Headaches- Symptoms, Types and Treatment

There are a numerous reasons for headaches. Many questions need to be asked first before some diagnosis can be made.

Evaluation

Some of the questions for a detailed evaluation of headaches are:

1. Frequency of headaches
2. Time of day headache occurs
3. Type of pain: dull, aching, throbbing, piercing, squeezing, or excruciating.
4. Other symptoms accompanying headache, possibly including: nausea, vomiting, dizziness, head/neck muscles contracting, senses (eyesight, hearing or touch) affected, tearing and aversion to light.
5. Location of pain: one side of head, both sides of head, front or back of head, over or behind one eye.
6. How long do the headaches last? Hours, days?
7. Does ibuprofen (500) work and for how long?
8. Is the patient taking any natural remedies or herbs?
9. Do the headaches occur during sexual activity?
10. Were you under stress when the headache occurred?
11. Did you fall, bump your head, or suffer any head trauma?
12. What are your sleeping patterns?
13. Is there a history of headaches in your family?

Types of Headaches

On the basis of answers to the above questions, further evaluation is carried out and we try to classify headache in one of the below mentioned categories:

1) Tension-Type Headache – related to the tension and stress. Feels like band across the head. Starts usually in the evening. Accompanied by tense and tender neck muscles.

2) Migraine Headache – commonly occurs on one side of head. Triggered by some event, smell, noise, light etc. Aura is usually present. Accompanied by sensations like lightening, ringing. Feels like lying down in a dark room. Lasts for few hours.

3) Cluster Headache – mostly over the eyes. May be accompanied by tearing in one eye.

4) Rebound Headaches- These are medication induced headaches.  Over use of certain medicines can cause such headaches.

5) Headaches due to Sinusitis– commonly occurs over the eyes. May follow cold symptoms and nasal congestion.

Headache can occasionally be caused by bleeding, tumor, or infection inside the skull, or else by diseases involving teeth, eyes, or sinuses. Flu or any sickness that causes fever can also cause headache. Such headache is known as secondary headache because it is secondary to other problems.

Self Care

General measures to be taken:

• Drink plenty of water and other liquids
• Avoid dehydration and overheating
• Do not restrict salt in the diet
• Avoid heavy meals and excess alcohol as these may precipitate or exaggerate symptoms.
• Talk to your physician about any medications you are taking and ask if they might contribute to headaches.

Diagnostic Tests

• Blood Chemistry and Urinalysis
• CT Scan (computerized tomography) or MRI (magnetic resonance imaging)
• The CT or brain scan reveals sinus problems, tumors or strokes. Although MRI is costlier than the CT Scan, the MRI does not use iodine containing contrast dye and may be more definitive in picking up problems in the head. These scans can reveal skull fractures, malignant diseases, sinus problems, concussions, hematomas and other possible medical problems.
• Sinus X-Ray. Although the CT Scan and MRI provide more details, this test may be done if symptoms seem to point to sinus.
• Neurological and Ophthalmology Tests. Neurological tests focus on such diseases as epilepsy and other neurological diseases, while an eye pressure test will rule out glaucoma.

One may require a complete history and physical examination by a physician before reaching to any conclusion. In the meanwhile, Tylenol (acetaminophen) or ibuprofen may be taken for headache relief. Acetaminophen would be better if there is a tendency for stomach problem like gastritis.