Headache

What is a headache?

A headache is pain or discomfort in
the head or face. Headaches vary greatly in terms of the location and intensity of the
pain, and how often they occur. Almost all people have headaches during their life. The
brain tissue doesn’t have pain-sensitive nerve fibers and doesn’t feel pain. But, other
parts of the head can be responsible for a headache including:

  • A network of nerves that extends over the scalp
  • Certain nerves in the face, mouth, and throat
  • Muscles of the head, neck, and shoulders
  • Blood vessels found along the surface and at the base of the brain

Different types of headaches are
described below.

Migraine

In migraines, symptoms other
than pain occur as part of the headache. These may include nausea and vomiting,
lightheadedness, sensitivity to light (photophobia) and sound (phonophobia), and
other visual symptoms. Migraines also have distinct phases. But, not all people have
each phase. The phases of a migraine headache may include:

  • Premonition or prodromal phase. A change in mood or behavior may occur hours or days before the headache.
  • Aura phase. A group of visual, sensory, or motor symptoms can precede the headache. Examples include vision changes, hallucinations, numbness, changes in speech, and muscle weakness.
  • Headache phase. This is the period
    during the actual headache with throbbing pain on one or both sides of the head.
    Sensitivity to light and motion are common, as are depression, tiredness
    (fatigue), and anxiety.
  • Resolution phase. Pain lessens
    during this phase, but may be replaced with tiredness, irritability, and trouble
    concentrating. Some people feel refreshed after an attack, others don’t.

Tension headaches

Tension headaches are the most
common type of headache. Stress and tight muscles are often factors in tension-type
headaches. These are common symptoms of a tension-type headache:

  • Slow onset of the headache
  • Head usually hurts on both
    sides
  • Pain is dull or feels like a band
    or vice around the head
  • Pain may be in the back part of the
    head or neck
  • Pain is mild to moderate, but not
    severe

Tension type headaches typically don’t cause nausea, vomiting, or sensitivity to
light.

Cluster headaches

Cluster headaches usually occur in a series that may last weeks or months.


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These are the most common symptoms of a cluster headache:

  • Severe pain on one side of the head, usually behind one eye
  • The eye that is affected may be red and watery with a droopy lid and small pupil
  • Swelling of the eyelid
  • Runny nose or congestion
  • Swelling of the forehead

What causes a headache?

Headaches are classified as primary or secondary.

  • A primary headache means the headache
    itself is the main health problem. but other factors such as muscle tension or
    exposure to certain foods may be triggers. Other things that may help cause the
    headache include medicines, dehydration, or hormone changes.
  • A secondary headache is related to an
    underlying health condition. An example of this would be a headache caused by a neck
    injury, eye problems, or an infection in the jaw, teeth or sinus .

What are the symptoms of a headache?

Headache symptoms depend on the type of headache. The frequency of headaches and the intensity of the symptoms may vary, too. Typical headache symptoms include:

  • Slow start of the headache
  • Head usually hurts on both sides
  • Pain is dull or feels like a band or vice around the head
  • Pain may be in the back part of the
    head or neck
  • Pain is mild to moderate, but not severe

Tension type headaches typically
don’t cause nausea, vomiting, or sensitivity to light (photophobia).

The symptoms of a headache may look
like other health conditions. Always see your healthcare provider for a diagnosis.

How is a headache diagnosed?

Your doctor will ask about your
health history. He or she will also do a physical exam and certain tests.

Questions commonly asked during the exam may include:

  • When do headaches occur?
  • What is the location of the
    headache?
  • What do the headaches feel like?
  • How long do the headaches last?
  • Have there been changes in behavior or
    personality?
  • Do changes in position or sitting up
    cause the headache?
  • Do you have trouble sleeping?
  • Do you have a history of stress?
  • Do you have a history of head
    injury?
  • Do you have other symptoms during a headache?

If your doctor suspects migraine or
tension-type headaches and the nervous system exam is normal, you may not need any
further testing. But it is not a primary type headache, or if you have uncommon
symptoms, other tests may be done to find the cause.

Tests used to find the cause of a headache may include:

  • Blood tests. Various blood and other
    tests may be done to check for underlying conditions.
  • Sinus X-rays. An imaging procedure
    done to look for congestion or other problems that may be corrected.
  • MRI. A test that uses a combination
    of large magnets, radio waves, and a computer to produce detailed images of organs
    and structures within the body.
  • CT scan. An imaging test that uses
    X-rays and computer technology to make detailed images  of the body. A CT scan shows
    detailed images of bones, muscles, fat, and organs. CT scans are more detailed than
    general X-rays.
  • Spinal tap (lumbar puncture). This may be done to rule
    out inflammation, infection, or high pressure in the spinal fluid


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