Headache
Services
A headache is pain anywhere in the region of the head or neck. It can be a symptom of a number of different conditions of the head and neck. During a given year, 90% of people suffer from headaches. Primary headaches account for more than 90% of all headache complaints, and of these, episodic tension-type headache is the most common. It is estimated that women are three times more prone than men to suffer from migraines. Migraines appear to be experienced by 30 – 40%of the population.
The brain itself is not sensitive to pain, because it lacks pain receptors. However, several areas of the head and neck do have pain sensors and can thus sense pain. These include the extracranial arteries, large veins, cranial and spinal nerves, head and neck muscles, and the meninges. Headache often results from traction to or irritation of the meninges and blood vessels. The pain receptors may also be stimulated by factors other than head trauma or tumors and cause headaches. Some of these include stress, dilated blood vessels, and muscular tension.
Primary Headaches
The most common types of headache are the “primary headache disorders”, such as tension-type headache and migraine. They have typical features; migraine, for example, tends to be pulsating in character, affecting one side of the head, associated with nausea, disabling in severity, and usually lasts for hours to days. Rarer primary headache disorders are trigeminal neuralgia (a shooting face pain), cluster headache (severe pains that occur).
Secondary Headaches
Headaches may be caused by other problems elsewhere in the head or neck. For example cervicogenic headache (pain arising from the neck muscles). Medication overuse headache may occur in those using excessive painkillers for headaches, paradoxically causing worsening headaches. A number of characteristics make it more likely that the headache is due to potentially dangerous secondary causes; some of these may be life-threatening or cause long-term damage. A number of “red flag” symptoms therefore means that a headache warrants further investigations, usually by a specialist. The red flag symptoms are a new or different headache in someone over 50 years old, headache that develops within minutes (thunderclap headache), inability to move a limb or abnormalities on neurological examination, mental confusion, being woken by headache, headache that worsens with changing posture, headache worsened by exertion, visual loss or visual abnormalities, neck stiffness, fever, and headaches in people with HIV, cancer or risk factors for thrombosis. Headaches are most likely to be primary (non serious and self-limiting), some specific secondary headache syndromes may demand specific treatment or may be warning signals of more serious disorders. Differentiating between primary and secondary headaches can be difficult.
As it is often difficult for patients to recall the precise details regarding each headache, it is often useful for the sufferer to fill-out a “headache diary” detailing the characteristics of the headache. When the headache does not clearly fit into one of the recognized primary headache syndromes or when atypical symptoms or signs are present then further investigations are justified and neuroimaging [CT/MRI] is generally recommended. One type of treatment, however, is usually not sufficient for chronic sufferers and they may have to find a variety of different ways of managing, living with, and seeking treatment of chronic daily headache pains.
There are however two types of treatment for chronic headaches, i.e. acute abortive treatment and preventive treatment. Whereas the first is aimed to relieve the symptoms immediately, the latter is focused on controlling the headaches that are chronic.. The primary goal of preventive treatment is to reduce the frequency, severity, and duration of headaches. This type of treatment involves taking medication on a daily basis for at least 3 months and in some cases, for over 6 months.
Headache Clinic
Headache clinic is a speciality centre where the patients with headaches are evaluated in detail with different structured questionnaires by specialists in headaches and councillors. They are also given presentations about various headache disorders.
