Headaches

Facts
Classification
Primary headaches
When to consult a doctor
Diagnosis and treatment
Concussions
Other headaches

FAST FACTS

Did you know that the brain itself has no sensory pain receptors? A headache therefore originates from the tissues and structures that surround the skull and the brain It can affect the head, which is one of the most common sites of pain, and/or the upper neck Dehydration is a very common cause

CLASSIFICATION

The International Classification of Headache Disorders (ICHD-3), published by the International Headache Society, is as follows:

Primary headaches
Secondary headaches
Cranial neuralgias, central and primary facial pain, and other headaches

PRIMARY HEADACHES

A primary headache has a key cause and is not a symptom of an underlying condition. Common examples are tension headaches, migraines and cluster headaches

Tension headache The most common primary headache, which is felt as a dull, scattered and mild-to-moderate pain A tight sensation often occurs around the head, which may extend to or from the neck, lasting a few hours or several days In some cases, it can be triggered by stress It is usually diagnosed through the reported medical history, and sometimes entails a physical examination Treatment includes over the counter and/or prescription pain medication or muscle relaxants In some instances, stress management can be useful

Migraine The second most common cause of a primary headache, which usually involves a pulsating or throbbing pain It can affect one side of the head, or both In some cases, it is associated with nausea and/or vomiting and blurred vision Genetic and environmental factors may contribute It is usually diagnosed by means of clinical signs and symptoms Hormonal changes, bright lights and stress can be triggers Treatment includes over the counter and/or prescription pain medication – such as non-steroidal anti-inflammatory medication. Sometimes, anti-nausea medication may be indicated

Cluster headache This comes on suddenly and occurs in clusters in weekly or monthly episodes, with pain-free periods in between Severe pain is usually experienced around the eye, causing swelling and possibly drooping of the eyelid It is mostly diagnosed through clinical signs and symptoms Due to its speedy onset, it is usually treated with fast acting pain medication, specific injectables, and sometimes even with high-flow oxygen inhalation Alcohol should be avoided during a cluster period as it can make the attack worse

WHEN TO CONSULT A DOCTOR

Call upon your doctor if the headache is accompanied with:

A stiff neck
Trouble speaking, seeing or walking
Confusion or fainting
Sudden weakness or paralysis on one side of the body
Fever
Nausea and vomiting

Secondary headaches⁴

This describes a headache that is caused by an underlying condition, such as the following:

Concussion (a mild brain injury, often caused by a blow to the head)
Middle-ear infection (otitis media)
High blood pressure (hypertension)
Meningitis (inflammation of the membrane, and fluids around the brain and spinal cord)
Certain medications, and overuse of medications
Flu (influenza)
Bleeding in or around the brain
Stroke
Pressure-causing headgear
Brain tumour
Blood clot in the brain
Panic attack
So-called “brain freeze” when eating something cold, such as ice-cream
Grinding or clenching of the teeth at night (bruxism)

DIAGNOSIS

If the nature of the headache appears to be more complex than just a primary headache, the following additional diagnostic tests may be carried out:

Blood tests
X-rays
Brain scans

TREATMENT

The choice of treatment would depend on the cause, which can include:

Pain medication (non-steroidal anti-inflammatory or opioids)
Rehydration
Antibiotics
Anti-anxiety medication
Antibiotics
An intra-oral (in the mouth) device called a bite plate in cases of grinding or clenching
Anti-depressants
In cases of brain tumours, brain bleeds or a stroke, specialised medial interventions are required

IMPORTANT NOTE ON CONCUSSION5

It is important to always wear a mouth guard during contact sport, and where applicable, also headgear. A mouth guard not only protects the teeth but may also prevent a concussion!

CRANIAL NEURALGIAS, CENTRAL AND PRIMARY FACIAL PAIN, AND OTHER HEADACHES

This describes a specific type of headache caused by the inflammation of the nerves of the head and neck An example is trigeminal neuralgia, which is the inflammation of a nerve called the trigeminal nerve, resulting in intense and severe facial pain The cause is not always known, however, in some instances it may be due to a compressed nerve or an underlying disease that affects the entire body, such as multiple sclerosis Diagnosis is mostly based on signs and symptoms Treatment includes pain medication and sometimes anti-convulsant medication, surgery or radiation therapy

Medical References

The information on this website is meant to give general knowledge only. It is not medical advice and should not replace advice, diagnosis, or treatment from a doctor. It also doesn’t set a specific way that care should be given.Always talk to your doctor or a qualified healthcare professional if you have any health questions or concerns. Don’t ignore or delay getting medical help because of something you read on this website.Medical information is always changing, so the details on this site—or any sites it links to—might not be fully accurate or up to date. You should not use this information to make medical decisions for yourself or others. If you do, you are doing so at your own risk.