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Headache - GENERAL


  Definition:
A pain in the head from any cause. See also benign headache; migraine headache, classical; migraine headache, common; tension headache; and the cluster headaches documents.

Alternative names:
Cephalalgia; pain in the head.

Considerations:
Tension headache and migraine headaches account for 90% of all headaches.

Types:

  • Tension: muscle contraction
  • Vascular: migrain headache or cluster headache
  • Combination: tension and vascular

A headache that signals a potentially serious problem is one that:

  • involves sudden, violent pain
    • it could signal an aneurysm
  • gets worse over time and includes other symptoms such as nausea and vomiting, speech changes, personality changes, etc.
    • although rare, it could be a brain tumor or a TIA ("mini-stroke")
  • includes nausea, vomiting, fever, and a stiff neck
    • it could be a sign of meningitis

Common causes:
Tension headache is a common headache pattern that may or may not be associated with psychosocial stressors.

Migraine headaches, which are often preceded by fatigue, depression, and visual disturbance (light flash, loss of peripheral vision, etc.).

Cluster headaches, which are a variation of the migraine, are characterized by:

  • pain that occurs mostly in men, while typical migraines are more common in women.
  • pain that is often situated behind an eye and usually the same eye.
  • pain that comes on very suddenly and without warning.
  • pain that peaks within 5 to 10 minutes and disappears in less than an hour.
  • pain that is often triggered by alcohol.
  • pain that will awaken a person from sleep and occur several times a day for weeks and then stop.

Other causes of headaches:

  1. Sinusitis
  2. Fever
  3. Alcoholic hangover
  4. PMS
  5. Anxiety
  6. Dental problems like toothaches
  7. Tumours
  8. Trauma

Diagnostic tests that may be performed include:

  • head CT scan
  • head MRI
  • sinuses X-rays
  • temporal artery biopsy
  • lumbar puncture

Treatment:

  • Medication
  • Physical medicine rehabilitation
  • Psychotherapy