Headache

    Headache

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    Definition of headache

    Headache is pain in any region of the head. Headaches may occur on one or both sides of the head, be isolated to a certain location, radiate across the head from one point, or have a vise-like quality. A headache may be a sharp pain, throbbing sensation or dull ache. Headaches may appear gradually or suddenly, and they may last less than an hour or for several days.

    Causes of headache

    Your headache symptoms can help your doctor determine the cause and the appropriate treatment. Most headaches aren’t the result of a serious illness, but some may result from a life-threatening condition requiring emergency care.

    Headaches are generally classified by cause:

    Primary headaches
    A primary headache is caused by problems with or overactivity of pain-sensitive structures in your head. A primary headache isn’t a symptom of an underlying disease. Chemical activity in your brain, the nerves or blood vessels of your head outside your skull, or muscles of your head and neck — or some combination of these factors — may play a role in primary headaches. Some people may carry genes that make them more likely to develop such headaches.

    The most common primary headaches are:

    1. Cluster headache
    2. Migraine (with and without aura)
    3. Tension headache (medically known as tension-type headache)
    4. Trigeminal autonomic cephalalgia (TAC), including cluster headache and paroxysmal hemicrania

    There are other headache patterns that are generally considered types of primary headache but are less common. These headaches have distinct features, such as an unusual duration or pain associated with a certain activity. Although these headaches are generally considered primary, each of them could be a symptom of an underlying disease. These headaches include:

    1. Chronic daily headaches
    2. Cough headaches
    3. Exercise headaches
    4. Sex headaches

    Some primary headaches can be triggered by lifestyle factors, including:

    • Alcohol, particularly red wine
    • Certain foods, such as processed meats that contain nitrates
    • Changes in sleep or lack of sleep
    • Poor posture
    • Skipped meals
    • Stress

    Secondary headaches
    A secondary headache is a symptom of a disease that can activate the pain-sensitive nerves of the head. Any number of conditions — varying greatly in severity — may cause secondary headaches. Sources of secondary headaches include:

    1. Acute sinusitis
    2. Arterial tears (carotid or vertebral dissections)
    3. Blood clot (venous thrombosis) within the brain — separate from stroke
    4. Brain aneurysm (a bulge in an artery in your brain)
    5. Brain AVM (arteriovenous malformation) (an abnormal formation of brain blood vessels)
    6. Brain tumor
    7. Carbon monoxide poisoning
    8. Chiari malformation (structural problem at the base of your skull)
    9. Concussion
    10. Dehydration
    11. Dental problems
    12. Ear infection (middle ear)
    13. Encephalitis (brain inflammation)
    14. Giant cell arteritis (inflammation of the lining of the arteries)
    15. Glaucoma
    16. Hangovers
    17. Influenza (flu)
    18. Intracranial hematoma (blood vessel ruptures in the brain)
    19. Medications to treat other disorders
    20. Meningitis (inflammation of the membranes and fluid surrounding your brain and spinal cord)
    21. Monosodium glutamate (MSG)
    22. Overuse of pain medication
    23. Panic attacks
    24. Post-concussion syndrome
    25. Pressure from tight-fitting headgear, such as a helmet or goggles
    26. Pseudotumor cerebri (increased pressure inside the skull)
    27. Stroke
    28. Toxoplasmosis
    29. Trigeminal neuralgia (disruption of the nerve connecting the face and brain)

    Specific types of secondary headaches include:

    1. External compression headaches (a result of pressure-causing headgear)
    2. Ice cream headaches (commonly called brain freeze)
    3. Rebound headaches (caused by overuse of pain medication)
    4. Sinus headaches (caused by inflammation and congestion in sinus cavities)
    5. Spinal headaches (caused by low levels of cerebrospinal fluid, possibly the result of trauma, spinal tap or spinal anesthesia)
    6. Thunderclap headaches (a group of disorders that involves sudden, severe headaches)

    When to see a doctor

    Seek emergency care
    A headache can be a symptom of a serious condition, such as a stroke, meningitis or encephalitis. Go to a hospital emergency room or call 911 or your local emergency number if you have the worst headache of your life, a sudden, severe headache or a headache accompanied by:

    • Confusion or trouble understanding speech
    • Fainting
    • High fever, greater than 102 F to 104 F (39 C to 40 C)
    • Numbness, weakness or paralysis on one side of your body
    • Stiff neck
    • Trouble seeing
    • Trouble speaking
    • Trouble walking
    • Nausea or vomiting (if not clearly related to the flu or a hangover)

    Schedule a doctor’s visit
    See a doctor if you experience headaches that:

    • Occur more frequently than usual
    • Are more severe than usual
    • Worsen or don’t improve with appropriate use of over-the-counter drugs
    • Prevent you from working, sleeping or participating in normal activities
    • Cause you distress, and you would like to find treatment options that enable you to control them better