Headache’s/Migraine

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 the headaches occur. 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

There are over 150 types of headaches, but the most common types include:

Tension Headaches : Tension headaches are the most common type of headache among adults and teens. They cause mild to moderate pain and come and go over time. They usually have no other symptoms.

Migraine Headaches : Migraine headaches are often described as pounding, throbbing pain. They can last from 4 hours to 3 days and usually happen one to four times a month. Along with the pain, people have other symptoms, such as sensitivity to light, noise, or smells; nausea or vomiting; loss of appetite; and upset stomach or belly pain. When a child has a migraine, they may look pale, feel dizzy, and have blurry vision, fever, and an upset stomach. A small number of children’s migraines include digestive symptoms, like vomiting, that happen about once a month.

Cluster Headaches : These headaches are the most severe. You could have intense burning or piercing pain behind or around one eye. It can be throbbing or constant. The pain can be so bad that most people with cluster headaches can’t sit still and will often pace during an attack. On the side of the pain, the eyelid droops, the eye reddens, pupil gets smaller, or the eye makes tears. The nostril on that side runs or stuffs up.

They’re called cluster headaches because they tend to happen in groups. You might get them one to three times per day during a cluster period, which may last 2 weeks to 3 months. Each headache attack lasts 15 minutes to 3 hours. They can wake you up from sleep. The headaches may disappear completely (your doctor will call this remission) for months or years, only to come back later. Men are three to four times more likely to get them than women.

Chronic Daily Headaches : You have this type of headache 15 days or more a month for longer than 3 months. Some are short. Others last more than 4 hours.

Headaches are classified as primary or secondary.

•  A primary headache means the headache itself is the main medical problem, although other factors, such as muscle tension or exposure to certain foods, may be identified. Other contributing factors include medicines, dehydration, or hormone changes.
•  A secondary headache is related to an underlying medical condition. An example of this would be a headache due to neck injury, eye problems, jaw, teeth or sinus infection.

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 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 involve the back part of the head or neck
• Pain is mild to moderate, but not severe
• Tension type headaches typically do not cause nausea, vomiting, or sensitivity to light (photophobia).

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

Your doctor will want to do a comprehensive medical evaluation and diagnostic testing. He or she will also ask about your medical history, and do physical exam and certain tests.

Questions commonly asked during the exam may include: When do headaches occur?
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?

Is there a history of head injury?

Blood tests. Various blood chemistry and other lab tests may be run to check for underlying conditions.

Sinus x-rays. An imaging procedure done to evaluate for congestion or other problems that may be corrected.

Magnetic resonance imaging (MRI). A test that uses a combination of large magnets, radiofrequencies, and a computer to produce detailed images of organs and structures within the body.

Computed tomography scan (also called a CT or CAT scan). An imaging test that uses X-rays and computer technology to produce horizontal, or axial, images (often called slices) of the body. A CT scan shows detailed images of any part of the body, including the bones, muscles, fat, and organs. CT scans are more detailed than general X-rays.

The goal of treatment is to stop headaches from occurring. Effective headache management depends on finding what type of headache you have and may include:

• Avoiding known triggers, such as certain foods and beverages, lack of sleep, and fasting
• Changing eating habits
• Exercise
• Resting in a quiet, dark environment
• Medicines, as recommended by your healthcare provider
• Stress management

Migraine and cluster headaches may need specific medicine management including:

Abortive medicines – Medicines prescribed by your healthcare provider act on specific receptors in nerves and blood vessels in the head to stop a headache in progress.

Rescue medicines – Medicines bought over-the-counter, such as pain relievers, to stop the headache.

Preventive medicines – Medicines prescribed by your healthcare provider taken daily to reduce the onset of headaches.

Some headaches may need immediate medical attention including hospitalization for observation, diagnostic testing, or even surgery. Treatment is individualized depending on the underlying condition causing the headache. Full recovery depends on the type of headache and other medical problems that may be present.