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Health Tips
Headaches
Headaches
NIH - National Institute of Neurological Disorders and Stroke
What is a Headache?
When a person has a headache, several areas of the head can hurt, including a network of nerves that extends over the scalp and certain nerves in the face, mouth, and throat. The muscles of the head and the blood vessels found along the surface and at the base of the brain are also sensitive to pain because they contain delicate nerve fibers. The bones of the skull and tissues of the brain itself never hurt because they lack pain-sensitive nerve fibers. The ends of these pain-sensitive nerves, called nociceptors, can be stimulated by stress, muscular tension, dilated blood vessels, and others triggers of headache.
Vascular headaches (migraines are a kind of vascular headache) are thought to involve abnormal function of the brain's blood vessels or vascular system; muscle contraction headaches appear to involve the tightening or tensing of facial and neck muscles; and traction and inflammatory headaches are symptoms of other disorders, ranging from brain tumor to stroke to sinus infection. Some types of headache are signals of more serious disorders: sudden, severe headache; headache associated with convulsions; headache accompanied by confusion or loss of consciousness; headache following a blow on the head; headache associated with pain in the eye or ear; persistent headache in a person who was previously headache free; recurring headache in children; headache associated with fever; headache that interferes with normal life.
Physicians will obtain a full medical history and may order a blood test to screen for thyroid disease, anemia, or infections or x-rays to rule out a brain tumor or blood clots. CTs, MRIs, and EEGs may be recommended. An eye exam is usually performed to check for weakness in the eye muscle or unequal pupil size. Some scientists believe that fatigue, glaring or flickering lights, the weather, and certain foods may trigger migraine headaches.
Is There Any Treatment?
Not all headaches require medical attention. Some result from missed meals or occasional muscle tension and are easily remedied. If the problem is not relieved by standard treatments, a headache sufferer may be referred to an internist, a neurologist, or a psychologist. Drug therapy, biofeedback training, stress reduction, and elimination of certain foods from the diet are the most common methods of preventing and controlling migraine and other vascular headaches. Regular exercise can also reduce the frequency and severity of migraine headaches. Temporary relief can sometimes be obtained by using cold pack or by pressing on the bulging artery found in front of the ear on the painful side of the head.
What is the Prognosis?
About 90 percent of chronic headache patients can be helped.
Important Info for Kids
Kids Health
Kids (under 19 years) should NEVER take aspirin for a headache. Doctors think there may be a link between taking aspirin and getting a rare but dangerous disease called Reye syndrome (A disease which affects all organs of the body, but most lethally the liver and the brain. When Reye's Syndrome develops, it typically occurs when a person is beginning to recover from a viral illness. Abnormal accumulations of fat begin to develop in the liver and other organs of the body, along with a severe increase of pressure in the brain. Unless diagnosed and treated successfully, death is common, often within a few days. - National Reye Syndrome Foundation - http://www.reyessyndrome.org/what.htm)
Migraine Headaches
NIH - National Institute of Neurological Disorders and Stroke
Migraine headaches affect 28 million Americans, 75 percent of whom - roughly 21 million people - are women. Migraine symptoms occur in various combinations and include pain, extreme sensitivity to light and sound, nausea and vomiting. The pain of migraine is often described as an intense pulsing or throbbing pain in one area of the head. Some individuals can predict the onset of a migraine with tell-tale signs that include visual disturbances. This is called a migraine "aura."
Despite the fact that 1 in 4 households in the United States have someone affected by migraine headaches, migraine is still not considered by many employers and insurers to be a legitimate medical problem. Migraine, however, can cause significant disability and costs the American taxpayers $13 billion in missed work or reduced productivity annually.
For many years, scientists believed that migraines were linked to the dilation and constriction of blood vessels in the head. Investigators now believe that migraine is caused by inherited abnormalities in certain cell populations in the brain. Using new imaging technologies, scientists can see changes in the brain during migraine attacks. Scientists believe that there is a migraine pain center located in the brainstem, a region at the base of the brain. As neurons fire, surrounding blood vessels dilate and become inflamed, causing the characteristic pain of a migraine. In order to keep this process in check, prompt treatment is of the essence.
What causes migraines?
Though the causes are not precisely known, it is clear that migraine is a genetic disorder. For some forms of migraine, specific abnormal genes have been identified. People with migraine have an enduring predisposition to attacks triggered by a range of factors.
What triggers migraines?
Lack of food or sleep, exposure to light, or hormonal irregularities in women, can set off a migraine attack in individuals with the disorder. Anxiety, stress or relaxation after stress, and fatigue are also triggers.
Medications for migraine may be taken on a daily basis to prevent attacks. Some medications developed for epilepsy and depression may prove to be effective treatment options. Medicines can also be used to relieve pain and restore function during attacks. For some women suffering from migraines, hormone therapy may help. Stress management strategies, such as exercise, relaxation, biofeedback and other therapies designed to help limit discomfort, may also have a place in the migraine treatment arsenal.
Cluster Headaches
American Academy of Family Physicians
What is a Cluster Headache?
A cluster headache is a rare type of headache that is more common in men. Cluster headaches start suddenly. The pain is usually behind or around one eye and is very severe. The eye and nose on the same side as the pain may also become red, swollen and runny. Cluster headaches cause severe pain and restlessness. These headaches can be frightening to the sufferer and his or her family.
A cluster headache can last a few minutes or several hours, but it usually lasts for 30 to 45 minutes. Cluster headaches usually occur at the same time each day for several weeks, until the "cluster period" is over. Cluster periods usually last 4 to 8 weeks and may occur every few months. At other times, no cluster headaches will occur.
What causes cluster headaches?
The cause of cluster headaches is not known. Because of the regular pattern of severe attacks, experts think cluster headaches begin in the part of the brain that handles daily changes in body function. Cluster headaches do not appear to be related to other illnesses or to diseases of the brain. They do not seem to run in families.
How do I know if I have cluster headaches?
Your description of your headaches will help your doctor make the diagnosis. The time and pattern of attacks are very important, so keeping a diary of your pain will help. Family members or others who see you during a headache can also help by describing your appearance and behavior. Don't be embarrassed to tell your doctor about your attempts to relieve the pain (such as banging your head against furniture). These attempts are common, and talking about them will help your doctor judge how severe the headaches are.
Your doctor will also give you a physical exam. Tests will probably not be needed to diagnose cluster headaches, but your doctor may order tests to rule out other illnesses.
Can I do anything to prevent headaches once a cluster has started?
During a cluster period, it is important to keep to your usual routine, remain calm and avoid changing your sleep pattern. Once a cluster period has started, a change in sleep pattern, particularly taking an afternoon nap, seems to bring on the headaches.
Drinking alcohol will also bring on headaches during cluster periods. This happens very quickly--before you finish the first drink. Alcohol should be completely avoided until the cluster period is over. No foods have been blamed for starting cluster headaches. Stress may bring on attacks, and the headaches may start when you are relaxing after a stressful time. Medicine can help reduce the number of headaches during a cluster period.
What treatments are available?
Several treatments are available for cluster headaches. It is important to work with your doctor to pick the right treatment for you and work out a schedule for taking the medicines.
Is It a Migraine?
United States Food and Drug Administration
Migraines are "primary headaches," meaning they are not caused by an underlying medical condition such as a tumor. Two other forms of primary headaches are tension-type and cluster headaches.
Tension headaches are the most common type and are usually characterized by a steady ache rather than the throbbing pain that is typical of migraines.
Cluster headaches affect only about 1 percent of the population, mostly males. The headaches come in groups over weeks or months. The pain is very severe, usually centering around one eye, but rarely lasts more than an hour or two.
| | Migraine | Tension-Type | Cluster |
|---|
| Location of pain | one or both sides of head | both sides of head | one side of head |
| Duration of pain | 4 to 72 hours | 2 hours to days | 30 to 90 minutes |
| Severity of pain | mild, moderate or severe | mild or moderate | excruciating |
| Nausea, sensitivity to light, sound, odors | common | no | no |
| Redness or tearing of eyes; stuffy or runny nose | sometimes | no | yes |
(Source: "Migraine and Other Headaches: A Patient Guide to Headache Management," American Medical Association, copyright 1997)
Should You Call a Doctor?
Some headaches, called "secondary" headaches, result from another medical condition, ranging from a relatively harmless condition like the flu to a serious condition such as a tumor. Headaches very rarely result from a condition as serious as a tumor, but to be safe, the American Council for Headache Education recommends that you contact a health professional if your attacks start after age 50 or your headache:
- appears suddenly and is more severe and different from past headaches, or worsens over time
- is triggered by exertion, coughing, or bending
- is linked with a stiff neck and fever
- is accompanied by disturbed vision or speech or numbness, tingling or weakness in a part of the body
- makes it difficult for you to think and remember
- causes severe vomiting
- follows a head injury.
Resources
MAGNUM (Migraine Awareness Group: A National Understanding for Migraineurs), which uses art as a vehicle to help educate people about migraine. You can contact MAGNUM at:
113 South Saint Asaph Street, Suite 300
Alexandria, VA 22314
703-739-9384
www.migraines.org
American Council for Headache Education
19 Mantua Road
Mount Royal, NJ 08061
1-800-255-ACHE (1-800-255-2243)
www.achenet.org
National Headache Foundation
428 West Saint James Place, 2nd Floor
Chicago, IL 60614
1-800-843-2256
www.headaches.org
National Institutes of Health Neurological Institute
P.O. Box 5801
Bethesda, MD 20824
301-496-5751
www.ninds.nih.gov
National Institute of Neurological Disorders and Stroke Brain Resources and Information Network (BRAIN)
P.O. Box 5801
Bethesda, MD 20824
(800) 352-9424
www.ninds.nih.gov
American Council for Headache Education
19 Mantua Road
Mt. Royal, NJ 08061
achehq@talley.com
www.achenet.org
Tel: 856-423-0258 800-255-ACHE (255-2243)
Fax: 856-423-0082
National Headache Foundation
428 West St. James Place
2nd Floor
Chicago, IL 60614-2750
info@headaches.org
www.headaches.org
Tel: 773-388-6399 888-NHF-5552 (643-5552)
Fax: 773-525-7357
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