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Headaches

Generally, everyone will suffer at least one headache in their lives. Headaches can have adverse effects on the quality of life depending on their severity. It has been noted that most people who experience severe headache pain have difficulty in performing daily tasks.

Headaches are defined as a symptom of pain in the region of the head and can be throbbing, intense and distinct. Headaches can occur suddenly or slowly and can continue for a few hours or a few days.

Causes of Headaches

Headaches should be evaluated on the basis of accompanying symptoms. These could include nausea, sensitivity to light and sound and vomiting. Most headaches are not the result of serious illnesses although some situations may require emergency intervention. A neurologist will assist you in establishing the cause of your headaches and to determine suitable treatment.

Headaches are classified as primary and secondary:

Primary headaches

Primary headaches can be caused by the over-activity of the pain receptors in the brain and indicate that the pain is not due to another cause. The chemical activity in your brain including the nerves, the blood vessels surrounding the skull or the neck and head muscles and sometimes even a combination of these factors can play an important role in the formation of a headache.

Primary headaches are the most frequently occurring headaches:

  • Migraine (with or without aura)
  • Tension type headache
  • Trigeminal autonomic headaches: The most frequently occurring of these types of headaches are cluster type headaches.

There are primary headaches which occur less frequently and which can be associated with a specific activity. Although these types of headaches are considered primary headaches, they can sometimes be a symptom of an underlying disease. These headaches need to be diagnosed by your doctor. These are;

  • Cough induced headache
  • Exercise headache
  • Sexual activity headache

Some primary headaches can be triggered by different factors:

  • Alcohol, particularly red wine,
  • Certain foods, such as processed meats that contain nitrates,
  • Changes in sleep patterns or fatigue,
  • Bad posture,
  • Skipping meals,
  • Stress,
  • Changes in air pressure.

Secondary headaches

Secondary headaches are symptoms of a disease that can activate the pain-sensitive nerves of the head. Any number of conditions can cause secondary headaches.

Possible causes of secondary headaches include:

  • Acute sinusitis
  • Arterial tears (carotid or vertebral dissections)
  • Blood clot within the brain (venous thrombosis)
  • Brain aneurysm (a bulge in an artery in your brain)
  • Brain arteriovenous malformation (an abnormal formation of blood vessels in the brain)
  • Brain tumor
  • Carbon monoxide poisoning
  • Arnold- Chiari malformation (Structural development abnormalities in the base of your brain)
  • Head trauma
  • Dehydration
  • Dental problems
  • Ear infections
  • Encephalitis (brain inflammation)
  • Giant cell arteritis (inflammation of arterial lining)
  • Glaucoma
  • Excessive alcohol consumption, hangovers
  • High blood pressure (hypertension)
  • Flu
  • Intracranial hematoma (brain hemorrhage caused by blood vessel ruptures in and around the brain)
  • Medication taken to treat other conditions
  • Meningitis (inflammation of the membranes and fluid surrounding the brain and spinal cord)
  • Monosodium glutamate (MSG)
  • Overuse of pain medication
  • Panic attacks and panic disorder
  • Post-concussion syndrome
  • Pseudotumour cerebri (pressure increase in the skull), also known as idiopathic intracranial hypertension.
  • Stroke
  • Toxoplasmosis
  • Trigeminal neuralgia ( nerve irritation)

When should you visit a neurologist?

Headaches can sometimes be symptomatic of life threatening conditions including meningitis, paralysis, and encephalitis. If you are experiencing the sudden onset a headache or pain whose severity is increasing then you should go to the emergency room of a hospital or call 112.

  • Confusion or difficulty understanding speech
  • Fainting
  • High temperature, over 39-40 °C
  • Numbness on one side of your body, weakness
  • Difficulty seeing
  • Difficulty talking
  • Difficulty walking
  • Nausea or vomiting (if it cannot be attributed clearly to flu or a different cause)

Meeting the Neurologist

If you experience regular or intermittent headaches or if your headaches are accompanied by one or more of the symptoms below then we advise consulting a neurologist as soon as possible.

  • If the headache occurs more frequently or is more severe
  • If the headache is different to your usual experiences
  • If the headache prevents you from working, sleeping or participating in normal activities
  • If you would like to explore treatment options which will enable you to control your headaches better, then the neurologist will diagnose you correctly and will be able to ascertain whether or not you require a brain tomography or MRI examination which are usually unnecessary.