Headache - You Shoud Know About It || Nasren Nipa

Headache - You Shoud Know About It

Headache is defined as a pain arising from the head or upper neck of the body.The pain originates from the tissues and structures that surround the skull or the brain because the brain itself has no nerves that give rise to the sensation of pain (pain fibers).

Headache is one of the commonest symptoms experienced by 

humans.

Factors Triggering Headache:

-Stress.

-Lack of sleep.

-Fatigue.

-Hunger.

-Caffeine withdrawal.

-Weather changes

Causes of headache:

1.Primary Headache:

a)Migraine headache:

Symptom -

Symptoms of a migraine headache include severe throbbing pain or a pulsing sensation, usually on one side of the head,nausea, vomiting,extreme sensitivity to light and sound.Migraine attacks 

can last for hours to days, and the pain can be so severe that it interferes with your daily activities.

Cause-

Emotional triggers such as Stress, depression, anxiety,

excitement and shock,Physical causes such as Tiredness and insufficient sleep, shoulder or neck tension, poor posture, and physical overexertion,Low blood sugar and jet lag can trigger a migraine.

Treatment-

OTC painkillers, such as paracetamol, aspirin and ibuprofen, can help to reduce symptoms. Sumatriptan and Rizatriptan are prescription drugs used for migraine taken as pills, shots or nasal sprays as they can relieve many symptoms of migraine.

Migraine pain can also be relieved by Rest in a quiet, dark room,Apply a hot or cold compress across forehead or the back of neck,Try mindful meditation,Smell the lavender,Stay

hydrated,Massage your temples,Exercise.

b)Tension headache:

Symptom-

Symptoms of a tension headache include Dull, aching pain all over your head,around neck,forehead, scalp, or shoulder muscle.Sensation of tightness or pressure across your forehead or on the sides and back of your head.

Cause-

When neck and scalp muscles become tense or contract can be a response to stress, depression, head injury, or anxiety. They may occur at any age, but are most common in adults and older teens.

Treatment-

OTC pain relievers are usually the first line of treatment for reducing headache pain include the drugs aspirin, ibuprofen and naproxen. Prescription medications include naproxen,

indomethacin and ketorolac.Tension headache can also be relieved by Try to reduce stress,Make sure you sleep, exercise, and eat on a regular schedule,Make sure you practice good posture,Try not to strain your eyes when you use your 

computer,Get treatment for depression or anxiety if you have those health problems,Try using a headache diary.

c)Cluster headache:

Symptom-

Symptoms of a cluster headache include Excruciating pain that is generally situated in, behind or around one eye, but may radiate to other areas of your face, head and neck.it is One-sided pain,Restlessness,Excessive tearing,Redness of your eye on the affected side,Stuffy or runny nose on the affected side,Forehead 

or facial sweating on the affected side.

Cause-

The exact cause of cluster headaches is unknown, but cluster headache patterns suggest that abnormalities in the body's biological clock (hypothalamus) play a role.

Treatment-

Acute treatment of cluster headache are Briefly inhaling pure oxygen through a mask,Triptans(sumatriptan),Octreotide,Local anesthetics,Dihydroergotamine.Cluster headache can also be relieved by Stick to a regular sleep schedule,Avoid alcohol.

d)Exertion headache:

Symptom-

Symptoms of a exertion headache include Sudden onset of pulsating pain.Pain that lasts from 5 minutes to 48 hours. Headache accompanied by nausea, vomiting and sensitivity to sound and/or light. Often self-limiting; usually stops occurring in 3 – 6 months.

Cause-

Exertion headache occurs may be due to chronic coughing, strenous physical activity,after sex.Dehydration, sleep deprivation, blood pressure issues and your food and drink choices (such as chocolate, alcohol, caffeine) could all trigger an exertion headache after or during a workout.

Treatment-

Exertional headache usually respond well to ibuprofen as 1st line treatment,if not respond thenindomethacin and Beta blocker can be a option.Exertion Headache can also be relieved by Eat Well and Stay Hydrated,Carefully warming up and cooling down,Choose Your Exercise Carefully.

e)Hypnic Headache:

Symptom-

Symptoms of a hypnic headache include pain that usually throbs and spreads across both sides of head,nausea,sensitivity to light and sound.pain can range from mild to severe, it's usually bad enough to wake you up when you're sleeping.Hypnic headache begins during sleep and wakes the sufferer,then generally lasts 

15 to 180 minutes.

Cause-

Exact cause is unknows but hypnic headaches might be related to issues in the parts of the brain involved in pain management,

rapid eye movement sleep, and melatonin production.

Treatment-

Lithium carbonate, caffeine, melatonin, flunarizine,

indomethacin and topiramate have been successful in treating hypnic headache.

2.Secondary Headache:

a)Medication overuse headache:

Symptom-

Medication overuse headaches tend to Occur every day or nearly every day, often waking you in the early morning.

Cause-

Medication overuse headaches are caused by regular, long-term use of medication to treat headaches, such as migraines. Pain relievers offer relief for occasional headaches. But if you take 

them more than a couple of days a week, they may trigger medication overuse headaches.

Treatment-

To break the cycle of medication overuse headaches, you'll need to restrict your pain medication.Depending on the drug you're taking, your doctor may recommend stopping the medication right away or gradually reducing the dose.

b)Infection of Brain:

Cause-

A severe headache may result from viral infections that specifically attack the brain and its coverings,such as encephalitis and meningitis.Brain Abscess may be the another reason.

Symptom-

Along with headache,patient might complain of fever,

rash,malaise,sign of meningism(neckstiffness,photophobia,

positive kernigs sign) and sign of shock(increase pulse,decrease blood pressure).

Treatment-

Treatment will be given by doctor according to cause.

c)Brain Tumour:

Around 50% of people with a brain tumour had headaches as one of the complaints.It will be associated with other symptom 

like focal neurological sign,vomiting,raised intracranial pressure,

Idiopathic Intracranial Hypertension (IIH) may cause High blood pressure in the skull that leads to headaches almost every day and Other symptoms include nausea, obscured vision, double vision and throbbing noise in the ears and treatment will be given after diagnose properly by doing investigation.

d)Hemorrhagic Stroke:

Cause-

If a severe headache develops suddenly with no known cause, you might be having a stroke due to subdural hematoma,

subarachnoid hemorrhage,intracerebral hemorrhage.

Symptom-

This headache may be accompanied by dizziness,vomiting,focal neurological sign( paralysis of one side of body,difficulty in speech,difficulty in swallowing).

Treatment-

Treatment will be given after diagnose properly by doing investigation.

e)Sinus headaches:

Symptom-

Symptoms of sinus headaches may include Pain, pressure and fullness in your cheeks, brow or forehead,Worsening pain if you bend forward or lie down,Stuffy nose,Fatigue,Achy feeling in your upper teeth.

Cause-

Seasonal allergies,sinus blockage and sinusitis may be the cause of sinus headache.

Treatment-

Sinus headache may be relieved by Pain killer such as  aspirin,acetaminophen and ibuprofen,Decongestants nasal spray like oxymetazoline,Nasal steroid sprays,Antihistamines,steam,

Use salt water.

f)Hormone headaches:

Symptom-

Symptoms of hormonal headaches include headache,loss of appetite,fatigue,acne,joint pain,decreased urination,

lack of coordination,constipation,cravings for alcohol, salt, or chocolate.

Cause-

Causes of hormonal headaches have been linked to the female hormone estrogen.Estrogen controls chemicals in the brain that affect the sensation of pain.A drop in estrogen levels can trigger a headache such as headache before menstruation.

Treatment-

Hormone headache may be improved by taking anti-migraine medicines called triptans and a painkiller called mefenamic acid during menstruation.

g)Caffeine headaches:

Symptom-

A caffeine headache usually starts behind the eyes and then moves up the front of the head along with withdrawl symptoms like Sleepiness,Irritability,Lethargy,Constipation,Depression,

Muscle Pain, Stiffness, Cramping,Lack of Concentration.

Cause-

Caffeine is a naturally occurring stimulant found in coffee, tea, yerba mate, and chocolate, and it is added to many sodas and colas.when someone is too much caffeine addicted,then headache may be develop as caffeine withdrawl symptom as Caffeine narrows the blood vessels in brain,Without it,blood 

vessels of brain are widen resulting boost in blood flow develop headache.

Treatment-

Caffeine headache may be improved by over-the-counter (OTC) pain reliever,Apply topical peppermint oil,Stay hydrated,Apply an ice pack,Stimulate your pressure points,Get some rest,Satisfy your caffeine craving.

h)Hangover headache:

Symptom-

Depending on what and how much you drank alcohol ,you may develop Fatigue and weakness,Excessive thirst and dry mouth,

Headaches and muscle aches,Nausea, vomiting or stomach pain,Poor or decreased sleep,Increased sensitivity to light and sound,Dizziness or a sense of the room spinning,Shakiness.

Cause-

Ethanol's diuretic effects can develop dehydration and Vasodilation due to ethanol can stimulate certain brain nerves and result in pain.

Treatment-

Aspirin, ibuprofen (Motrin, other brands), and other NSAIDs except acetaminophen may help with the headache and the achy feelings.

i)Hypertension headaches:

Symptom-

A hypertension headache will usually occur on both sides of head and The headache pain tends to pulsate and often gets worse with physical activity.other symptoms include changes in vision, numbness or tingling, nosebleeds, chest pain, or shortness of breath.

Cause-

Hypertension Headache occurs when blood pressure becomes dangerously high.high blood pressure can cause headaches because it affects the blood-brain barrier.Hypertension can result in excess pressure on the brain, which can cause blood to leak from the blood vessels in this organ.

Treatment-

These types of headaches typically go away soon after the blood pressure is under better control.They shouldn’t reoccur as long as high blood pressure continues to be managed.If you have high blood pressure, you should only take aspirin if your blood pressure is currently well-controlled.

j)Rebound headaches:

Symptoms-

Rebound headaches have episodic attacks of multiple symptoms 

(pain, nausea, vomiting, sensitivity to light and sound) but they go back to their usual state of health in between attacks.

Cause-

Rebound headaches are caused by regular, long-term use of medication to treat headaches, such as migraines.Pain relievers offer relief for occasional headaches. But if you take them more than a couple of days a week,they may trigger.

Treatment-

Rebound headache may be improved by Aspirin,Sinus relief medications,Acetaminophen,NSAIDs such as ibuprofen and 

naproxen,Sedatives for sleep,Codeine and prescription narcotics,

OTC combination headache remedies containing caffeine.

k)Post-traumatic headache:

Cause-

Post-traumatic headache (PTHA) is defined as a secondary headache that develops within 7 days after head trauma,

Traumatic Brain Injury (TBI) or after regaining consciousness following head trauma.

Post-traumatic headache happens because of the muscle tensing that goes on during your injury. Or your blood vessels may narrow, keeping blood from flowing to your head like it normally does.

Symptom-

When you get a post-traumatic headache that feels like a migraine or tension type headache, it could be moderate to severe in intensity.You could be sensitive to light or sound. Post-traumatic headaches can be constant or only happen every once in a while.

Treatment-

Post traumatic headache may be improved by taking anti-inflammatories or pain medications, including those used for migraine (e.g., triptans)during 1st few weeks.Antidepressants, blood pressure pills and anti-seizure medication are commonly used preventive drugs for post-traumatic headache.

l)Referred Headache:

Cause-

Referred headaches may be felt in the head even though the site of disease is elsewhere by eye disorders such as glaucoma,

infections or tumours of the nasal sinuses, dental infections, and arthritis of the neck.

Treatment-

Referred headache may be relieved by taking NSAID such as aspirin or ibuprofen and treatment of actual cause.

How to Diagnose Headache:

Headache mostly diagnosed by history given by patient and by clinical examination but to exclude the cause sometimes investigation may be needed.It Varies According to Cause of Headache.

1. Blood Chemistry and Urinalysis-

These tests may determine many medical conditions including diabetes,thyroid problems, and infections, which can cause headaches.

2. CT Scan Of Head

3. MRI of Brain

4.  Sinus X-Ray

5.EEG

6. Eye Examination

7. Lumber Puncture for CSF Analysis

Most people with headaches can feel much better by making lifestyle changes,learning ways to relax, and sometimes by taking medicines.Diagnosing headache involves differentiating between the most common forms of headache and those that may indicate an underlying illness.

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