Pain in head is called headache. Almost everybody experiences headache. One episode of mild headache may be due to exertion, stress or some causes which may not be alarming and you can afford to neglect.
Headache is a very common symptom. Almost everyone experiences headache at some stage of life. Despite of being so common it becomes sometimes it becomes a matter of concern.
So, one should not panic and should analyze the severity of the problem and proceed further for seeking the medical attention & investigations.
Lot of literature is available on the causes of headache but I would like to overly simplify this topic so that one can have an overview.
If headache is associated with exertion at the end of the working day and is over the vertex, frontal or occipital region of the skull and is relieved on taking rest or head massage, one should not worry.
if someone is very stressed and there is obvious stress then there can be psychogenic headache. That person should adopt the less stressful lifestyle and practice relaxation exercise , yoga , and very rarely psychotherapy or some medicines may be required.
Maxillary or frontal sinusitis also causes headache.
Redness of eyes, frequent sneezing, cold , allergy may also cause headache.Cluster headache occurs in clusters.
In older persons headache may occur due to hypertension and temporal arteritis.
Refractive errors like myopia and hypermetropia may also cause periorbital pain and headache especially in young children going to school. So vision examination should also be done in patients complaining of headache.
If a child complains of headache it may due to refraction error in vision. Common cause is myopia when someone complains of difficulty in seeing distant things. child may not read the letters written on blackboard in a class and there may be decrease in scholastic performance in school. Another refractive error is hypermetropia which is difficulty in reading the small letters. Although, this is a common problem in people over 40 years of age, it is becoming more common in childrenm because of too much indulgence in mobile games, computer games and less outdoor play activities.
So common cause of Persistent headache is refractive error of vision.
Other common cause is sinusitis. Such patients will have frequent history of nasal infections, pain over the bony air sinuses in skull. Maxillary sinusitis, frontal air sinusitis may be diagnosed by tenderness and X-Ray Skull. Sometimes CT scan may be needed. Most of the patients are treated by antibiotics.
Common cause of headache is tension headache. In this type is headache pain is over the vertex, i.e, top of the head. Since the muscles are under continuous tension , such headache will diminish if head massage is given.
Hypertension, anemia may also cause headache.
Migraine is very common and typically paroxysm of throbbing type of headache on irregular intervals, unilateral, associated with vomiting. Migraine is more common in females. There are many variants of migraine.Migraine is the diagnosis of exclusion. Before labelling a ptient with this diagnosis all other causes must be ruled out, like anemia, brain tumor, hemorrhage, infection. CT scan or MRI of the brain rules out any intracranial mass occupying lesion. It is normally hemicranial,i.e., involes one half of the head. It is usually throbbing headache and associated with nauses and vomiting. Migraine is recurrent and gradually the duration between episodes become less.
What should not be missed?
Any physician or person should not ignore headache due to brain tumor and subarachnoid hemorrhage due intracranial aneurysm rupture.
How to recognize headache due to brain tumor? Usually progressive, associated with vomiting, temporarily relieved after vomiting, may be associated with blurring of vision ( due to papilloedema), or other neurological deficit.
How to recognize headache due to subarachnoid hemorrhage caused by rupture of intracranial aneurysm? It is sudden onset severe headache ( bolt from blue, thunderclap headache which a patient in the age group of 4th - 5th decade, says that he or she had never experienced such type of headache in life time. Sometimes headache may not be so severe and it is called warning leak. There may be associated neck rigidity.
What is the most valuable investigation in the management of headache??
If Visual examination of the patient is performed and Non contrast CT scan of the head is advised one will never be guilty of missing a life threatening brain condition like SAH ( subarachnoid hemorrhage and brain tumor) and it will guide the further course of treatment.
Sudden onset severe headache in a person of about 40 to 50 years of age which is so intense as patient describes that he or she had never experienced such headache in his or her life time,"Bolt from Blue," is typical of spontaneous subarachnoid hemorrhage ( SAH) due to rupture of intracranial aneurysm.
Head trauma, cervical spondylosis may also cause headache.
Headache associated with seizures is alarming. CT scan or MRI of the brain must be done.
Headache is a very common symptom. Almost everyone experiences headache at some stage of life. Despite of being so common it becomes sometimes it becomes a matter of concern.
So, one should not panic and should analyze the severity of the problem and proceed further for seeking the medical attention & investigations.
Lot of literature is available on the causes of headache but I would like to overly simplify this topic so that one can have an overview.
If headache is associated with exertion at the end of the working day and is over the vertex, frontal or occipital region of the skull and is relieved on taking rest or head massage, one should not worry.
if someone is very stressed and there is obvious stress then there can be psychogenic headache. That person should adopt the less stressful lifestyle and practice relaxation exercise , yoga , and very rarely psychotherapy or some medicines may be required.
Maxillary or frontal sinusitis also causes headache.
Redness of eyes, frequent sneezing, cold , allergy may also cause headache.Cluster headache occurs in clusters.
In older persons headache may occur due to hypertension and temporal arteritis.
Refractive errors like myopia and hypermetropia may also cause periorbital pain and headache especially in young children going to school. So vision examination should also be done in patients complaining of headache.
If a child complains of headache it may due to refraction error in vision. Common cause is myopia when someone complains of difficulty in seeing distant things. child may not read the letters written on blackboard in a class and there may be decrease in scholastic performance in school. Another refractive error is hypermetropia which is difficulty in reading the small letters. Although, this is a common problem in people over 40 years of age, it is becoming more common in childrenm because of too much indulgence in mobile games, computer games and less outdoor play activities.
So common cause of Persistent headache is refractive error of vision.
Other common cause is sinusitis. Such patients will have frequent history of nasal infections, pain over the bony air sinuses in skull. Maxillary sinusitis, frontal air sinusitis may be diagnosed by tenderness and X-Ray Skull. Sometimes CT scan may be needed. Most of the patients are treated by antibiotics.
Common cause of headache is tension headache. In this type is headache pain is over the vertex, i.e, top of the head. Since the muscles are under continuous tension , such headache will diminish if head massage is given.
Hypertension, anemia may also cause headache.
Migraine is very common and typically paroxysm of throbbing type of headache on irregular intervals, unilateral, associated with vomiting. Migraine is more common in females. There are many variants of migraine.Migraine is the diagnosis of exclusion. Before labelling a ptient with this diagnosis all other causes must be ruled out, like anemia, brain tumor, hemorrhage, infection. CT scan or MRI of the brain rules out any intracranial mass occupying lesion. It is normally hemicranial,i.e., involes one half of the head. It is usually throbbing headache and associated with nauses and vomiting. Migraine is recurrent and gradually the duration between episodes become less.
What should not be missed?
Any physician or person should not ignore headache due to brain tumor and subarachnoid hemorrhage due intracranial aneurysm rupture.
How to recognize headache due to brain tumor? Usually progressive, associated with vomiting, temporarily relieved after vomiting, may be associated with blurring of vision ( due to papilloedema), or other neurological deficit.
How to recognize headache due to subarachnoid hemorrhage caused by rupture of intracranial aneurysm? It is sudden onset severe headache ( bolt from blue, thunderclap headache which a patient in the age group of 4th - 5th decade, says that he or she had never experienced such type of headache in life time. Sometimes headache may not be so severe and it is called warning leak. There may be associated neck rigidity.
What is the most valuable investigation in the management of headache??
If Visual examination of the patient is performed and Non contrast CT scan of the head is advised one will never be guilty of missing a life threatening brain condition like SAH ( subarachnoid hemorrhage and brain tumor) and it will guide the further course of treatment.
Sudden onset severe headache in a person of about 40 to 50 years of age which is so intense as patient describes that he or she had never experienced such headache in his or her life time,"Bolt from Blue," is typical of spontaneous subarachnoid hemorrhage ( SAH) due to rupture of intracranial aneurysm.
Head trauma, cervical spondylosis may also cause headache.
Headache associated with seizures is alarming. CT scan or MRI of the brain must be done.
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