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• What are the causes of headaches?
• How many types of headaches?
• What is headache symptom that requires immediate medical attention?
• How is headache diagnosed?
• How is headache treated?
• How to relieve primary headache?
• What is the prevention of headaches?

Headache

Headaches manifest as a sensation of pressure pain anywhere in the head. They exhibit considerable variation in character, ranging from squeezing, throbbing, sharp shooting to dull pain. The onset of headaches can be gradual or sudden, and their duration can span from less than an hour to several days. Pain can occur on one or both sides of the head, in a single location, or spread diffusely throughout the head. Certain types of headaches can stem from life-threatening brain disorders and should receive a prompt evaluation by a medical professional in a hospital setting for a comprehensive investigation.

What are the causes of headaches?

Headaches arise from the activation of pain-sensitive structures within the head, along nerves, or in blood vessels, often resulting from stretching, inflammation, or injury. These stimuli trigger nociceptive nerve fibers in and around the head to convey pain signals to the central nervous system, culminating in the perception of headaches.

How many types of headaches?

Headaches are of diverse types, categorized based on their underlying cause, location, and character, including both general headaches and those arising from severe medical conditions necessitating urgent medical attention. The two categories of headaches are primary headaches and secondary headaches.

Primary headaches

Primary headaches are typically harmless but may disrupt daily activities and quality of life. They are not due to underlying diseases or severe, life-threatening conditions requiring immediate medical attention. These headaches arise from the hypersensitivity of pain-sensitive structures. Primary headaches may have a genetic predisposition. Common types of primary headaches include:

• Tension-type headaches, often attributed to stress, overexertion, and inadequate rest, typically manifest as bilateral pain or temporal pain radiating to the back of the neck. These headaches can persist from 30 minutes to several days, with symptoms often arising in the afternoon or evening.
• Migraine headaches arise from a complex interplay of factors, including chemical imbalances in the brain, abnormal blood vessel dilation, hereditary predisposition, hormonal fluctuations in women, stress, inadequate sleep, and exposure to specific environmental triggers such as heat, light, sound, chemicals, or scents. These headaches typically manifest as a throbbing unilateral pain, which may shift between the sides of the head. The intensity of the pain ranges from moderate to severe, and the duration can extend from 4 hours to 3 days. Migraine headaches are often associated with nausea, vomiting, dizziness, vertigo, and photophobia or numbness.
• Cluster headaches arise from dysfunctions and chemical changes in the brain, the trigeminal nerve (cranial nerve V), and surrounding blood vessels. These headaches typically manifest as severe unilateral, intermittent sharp shooting and throbbing pain, often accompanied by tearing, sweating, ptosis (drooping eyelids), and pupil constriction. Cluster headaches tend to occur in bunches, with 1-3 episodes per day lasting two weeks to three months before abruptly subsiding.
• New daily persistent headaches (NDPH) are unilateral or bilateral sudden-onset headaches that individuals have never experienced. These headaches are accompanied by symptoms such as nausea, vomiting, and photophobia (sensitivity to light), mimicking migraine headaches. NDPH is a rare type of headache with an unknown etiology. Inflammation in the brain's surrounding structures, infection, brain tumors, or a vascular issue are likely the causes. Accurate diagnosis of NDPH requires a comprehensive evaluation by an experienced medical specialist.

What are the triggering factors for primary headaches?

• Visual stimulation: Exposure to bright or flashing lights.
• Musculoskeletal strain: Prolonged eye use, neck strain, or improper posture.
• Hormonal fluctuations: Menstrual cycles in women.
• Environmental factors: Extreme temperatures, both hot and cold.
• Psychological stress: Emotional and mental stressors.
• Dietary factors: Consumption of alcoholic beverages and certain foods, such as processed meats containing nitrates.
• Sleep disturbances: Irregular sleep patterns and sleep deprivation.
• Physical exertion: Excessive exercise or strenuous activities.
• Nutritional factors: Fasting or skipping meals.

Typically, primary headaches are usually harmless but may interfere with daily life.

Secondary headaches

Secondary headaches encompass headaches spectrum arising from underlying diseases or disorders within or outside the cranial proper. These headaches can range from benign and treatable conditions to life-threatening emergencies requiring immediate medical attention.

• Secondary headaches originating from structures beyond the skull and neck, such as sinus headaches, dehydration headaches, headaches from muscle and fascial pain in the head and neck, severe toothache radiating to the head, glaucoma, and temporomandibular joint (TMJ) disorders.
• Secondary headaches caused by structures within the skull, such as the brain or blood vessels, and nerves, such as brain tumors, intracerebral hemorrhage (bleeding within the brain), hemorrhagic stroke, increased intracranial pressure (ICP), meningitis, cerebral artery aneurysm, hydrocephalus (excessive accumulation of cerebrospinal fluid in the brain), brain abscess, brain cancer, and cerebral venous sinus thrombosis (CVST).
• Sinus headaches are headaches that occur all over the face in the sinus areas, such as the forehead, bridge of the nose, and eye sockets. Sinus headaches can be caused by a variety of factors, including the common cold, allergies, bacterial or fungal infections. Sinus headache sufferers will experience an obvious headache when they tilt their heads or bend over. They may have associated symptoms of fever, a swollen face, mucus, and a runny nose.
• Thunderclap headache is an abrupt and excruciating headache that strikes without warning. A thunderclap headache can signal a serious underlying medical condition, such as intracerebral hemorrhage, vasospasm (constriction of blood vessels in the brain), or cerebral venous sinus thrombosis (CVST).

What is headache symptom that requires immediate medical attention?

• Sudden, severe headache
• The worst headache ever to occur in a lifetime.
• Headache accompanied by symptoms such as fever, convulsions, lethargy, confusion, behavioral changes, weakness in the arms and legs, numbness, slurred speech, facial or mouth drooping, or blurred vision.
• Chronic headaches or frequent headaches that require regular painkillers
• Headaches occur only when coughing or sneezing.
• New-onset headaches after age 50
• Headaches during pregnancy

How is headache diagnosed?

The neurologist will diagnose headaches after performing an initial physical examination and taking a detailed history. Please keep in mind that this is the most important part of effectively diagnosing the cause of headaches, as it includes the location of the headache, symptoms of the headache, how much it hurts, how often it hurts, how long the pain persists, and whether it is constant or worsening. A detailed history also includes whether the headache affects with daily activities, whether there are any other symptoms associated with headaches such as fever, how to relieve pain, a medication that is taken on a regular basis, congenital disease, a history of accidents or concussions to the head, and lifestyle. The neurologist will then perform additional diagnostic tests using the following methods:

• MRI is a highly advanced 3D imaging technique that utilizes powerful magnets and radio waves to produce detailed images of the brain and its internal structures. This non-invasive and painless procedure allows neurologists to visualize the intricacies of the skull's contents, enabling them to identify potential causes of headaches, such as tumors, cancerous growths, intracerebral hemorrhage, stroke, ruptures or blockages of cerebral arteries, and degenerative changes. The resulting images, processed by a sophisticated and efficient AI system, provide valuable information in determining the underlying source of the headache.
• PET/CT scan is a sophisticated dual-modality imaging technique combining nuclear medicine and X-ray imaging. It integrates the functional information obtained from positron emission tomography (PET) scans with the detailed anatomical structures of 3D computed tomography (CT) scans. This powerful combination allows clinicians to visualize structural abnormalities and internal pathology, including blood vessels, tumors, and cancerous growths, which could be the underlying cause of headaches. PET/CT scans also play a crucial role in evaluating treatment outcomes, assessing prognosis, and guiding treatment decisions, ultimately enhancing the effectiveness of headache management.

How is headache treated?

Based on the results of the diagnostic tests, the neurologist will consider headache treatment for either the primary or secondary headache, considering individual factors such as headache triggers, overall health status, medical history, age, duration of the headache, or severity of the headache.

Treatments options for primary headaches

• Medications: Doctors may consider prescribing medications such as nonsteroidal anti-inflammatory drugs (NSAIDs) such as Ibuprofen and Naproxen, as well as migraine-relieving drugs such as Triptans and Ergot, should be taken under the supervision of a physician.
• Preventive medications: Doctors may consider prescribing headache-prevention medications to those who have frequent headaches in order to reduce the frequency and severity of headaches.
• Stress management includes breathing, exercising, muscle relaxation, or music therapy.
• Avoiding headache-inducing factors that may trigger headaches, such as stress, lack of sleep, and alcohol consumption,
• Biofeedback, a therapy that involves practicing body control to achieve balance, is performed by a doctor in collaboration with hospital specialists to assess the function of vital signs including breath, pulse, body temperature, muscle tension, or brain activation.
• Botox injections (Migraine headaches considered by the doctor)
• Physical therapy
• Acupuncture

Treatment options for secondary headaches 

Treatment options for secondary headaches caused by disease or abnormalities within the skull, such as intracerebral hemorrhage, stroke, brain tumor, or brain cancer, include:

• Medication treatments
• Surgery
• Radiotherapy
• Chemotherapy
• Targeted therapy
• Immunotherapy

How to relieve primary headache?

Primary headache symptoms, such as minor or occasional headaches, can be relieved with over-the-counter pain relievers provided by a pharmacist, as well as by eating five food groups and engaging in stress-relieving activities. However, if the symptoms do not improve or if there is a severe headache that interferes with their daily lives, it is necessary to seek medical attention right away. How to relieve a primary headache includes the following steps:

•    Over-the-counter pain relievers such as paracetamol and Ibuprofen
•    Take a break from long periods of screen time or hard work.
•    Hot or cold compress applies to the head.
•    Stretching
•    Massage of the head, neck, and back
•    Relaxing in a low-light, quiet environment
•    Going for a relaxing walk
•    Listening to music
•    Playing with beloved pets

What are the complications of headaches?

Headaches, though generally not life-threatening, can lead to several complications, particularly in the context of treatment and underlying causes.

• Complications of primary headaches, such as the use of nonsteroidal anti-inflammatory drugs (NSAIDs), can result in abdominal pain and gastrointestinal bleeding. Headache from an overdose of painkillers may cause withdrawal if medication is stopped. Migraine headaches that last more than 72 hours without relief, as well as migraine headaches that cause a migrainous infarction or migraine-associated seizures.
• Complications of secondary headaches frequently arise from the underlying cause of the headache, such as a brain tumor or brain cancer, which is the true cause and requires treatments such as medications, surgery, or chemotherapy to treat the symptom.

Those suffering from chronic headaches or headache complications should consult a medical professional for a thorough diagnosis and a systematic treatment plan to treat headaches and complications effectively.

What is the prevention of headaches?

• Primary headaches can be prevented by pinpointing the cause of the headache or factors that trigger primary headaches, which vary from person to person, and changing those behaviors, such as getting enough sleep, not skipping meals and drinking enough water, limiting the amount of caffeine or alcohol consumption on a daily basis, exercising in moderation, implementing stress-reduction techniques, practicing meditation, or even avoiding the smell of certain perfumes that may trigger headaches to prevent recurrence.
• Secondary headaches are those that cannot be prevented or avoided because they are caused by disease or abnormalities in the head structure. Individuals experiencing sudden severe headaches with no known cause, headaches associated with other symptoms, accidents, or head concussions should seek a thorough diagnosis from a neurosurgery specialist to accurately diagnose the disease and provide effective treatment in order to recover from the disease as soon as possible, or at least alleviate headaches.

Frequent headaches, Persistent headaches, and Early detection can help relieve

Those who have at least one headache per week, those who take painkillers every day or almost every day, but their headaches do not go away, or those who have more and more headaches with no signs of improvement should see a neurosurgical specialist for a thorough diagnosis, which includes taking a history, neurological examinations, and imaging studies to accurately identify the underlying cause of the headache and help receive effective treatment promptly. Early diagnosis can lead to timely treatment, prevent further complications, and allow you to live your daily life unconditionally.

Related Package

• Headache Screening Package