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Headaches are among the most common health problems people seek professional help for. Most cases are non-serious forms that may sometimes be a manifestation of a more serious condition.
A headache is an unpleasant subjectively perceived sensation. It is commonly described as being sharp, stabbing or dull. It can be localised on the forehead, around the eyes, behind the ear, at the top of the temple or the back of the neck.
A headache may originate from the neck, teeth or other structures close to the head. It almost always accompanies febrile illnesses or upper respiratory tract infections and various viruses as well as influenza and sinusitis.
Headache = cephalea / cephalalgia.
Cephalea is divided into different types, which are distinguished from each other by different characteristics.
An example of a common and frequently occurring pain is migraine or tension headache. The cluster form represents a less frequent type.
However, we also know a group of acute and severe pain. It accompanies high blood pressure, but also other serious, health and life-threatening conditions and diseases.
Not only in adults, but also children experience headache. This unpleasant sensation is usually nothing to worry about, but it may also be a cause for concern.
The headache takes the form of dull little bothersome attacks. But, people also experience intense discomfort that prevents them from carrying out normal daily activities.
It occurs on its own or in association with a range of complaints such as increased sensitivity to light and noise, lack of appetite, vomiting or fatigue and weakness.
In addition to the subjective perception, headache has a significant economic impact, as it can be responsible for being unable to work for days on end.
What's behind a headache?
Is it a serious illness or do I have a migraine?
What for a headache and how to get rid of it?
Headache takes different forms
Risk factors and triggers +and important questions
The headache can be benign or severe. It occurs frequently, repeatedly and in attacks. But, there are cases when a person has never had it all his life, and suddenly intense and the worst pain in life sets in.
These are only some of the characteristics that are evaluated for this health problem.
From a crude point of view, headache is divided into primary and secondary. A third, not always mentioned form is cranial neuralgia.
Classification of headaches into types:
- primary cephalea - idiopática, causa desconocida y sin daños en la estructura cerebral
- secondary cephalea - manifestación de otra enfermedad, puede haber daños estructurales
- cranial neuralgia - el dolor proviene de los nervios craneales
- trigeminal neuralgia
- neuralgia n. glossopharyngei
- optic neuritis
With this health problem, some questions and answers are important. This information provides a comprehensive view of the possible cause. However, the diagnosis is not always clear-cut and is supplemented by a special examination, for example by a neurologist.
The relevant questions are:
- What is the character of the pain? Is it dull, sharp, stabbing, throbbing?
- What is the localization of the pain? Is it in one place, or is it shifting, radiating somewhere, from somewhere?
- pain in the front, such as forehead and temples (temples), around the eye, behind/above the eye, around the eyebrow, between the eyebrows, behind/above the ear, on the temple, in the back of the head, radiating from the neck?
- How often does it occur or recur?
- the pain is episodic and recurs regularly
- it's the initial pain
- rapid onset
- acute onset
- how often during the day, month, year it repeats
- What is the intensity?
- the worst pain ever
- How long does it last?
- seconds to minutes
- days or daily
- How does it progress?
- as usual, as always
- or the course, character, intensity of the pain has changed
- What caused the pain? Is it a provoking factor, physical or psychological stress, sexual intercourse, fatigue, menstruation, food or medication?
- Are other difficulties also associated? Such as fatigue, sleepiness, sensitivity to light, sound, smell, inappetence, vomiting, tingling in the face, trembling of the hands, limbs, dry mouth?
- How does the treatment work? Do conventional analgesics help?
The first headache after the age of 40 is described as risky.
Also important is a personal history, during which information regarding other diseases (respiratory viral disease, high blood pressure, diabetes mellitus, etc.), injuries is obtained. Plus, the family history and the occurrence of diseases in the parents are also extracted.
Risk factors for developing difficulties and red flags
Sometimes it's good to sense the connection.
What does it mean?
The human body reacts to a number of environmental but also internal signals, for example a change in the weather or stress.
Risk factors, pain triggers:
- stress and mental strain
- fatigue and exhaustion
- sleep disturbances, sleep deprivation, excess sleep, headache at night waking from sleep, which again disturbs sleep and induces fatigue
- physical activity, sexual intercourse
- hormonal changes - especially in women during menstruation, ovulation and pregnancy
- too low or too high liquid intake
- hunger, low sugar, or too high
- diet and fluids such as alcohol, caffeine
Mind the red flags. What are they?
These are warning signs that no one should neglect and seek medical attention when they occur.
The medical literature also talks about yellow flags. The essence is the same, and a person is definitely advised to seek examination when spotting them.
Yellow and red flags = warning signs that point to a professional medical examination.
Table: Red flags and yellow flags
|Red Flags||Yellow flags|
|Serious warning signs||Suspicions = necessary to look for a secondary form|
The group of primary headaches is represented by migraine, which is often mentioned among people. Tension headache may co-occur.
Less common and well known is cluster headache and other rare primary headaches.
Primary pains is divided into:
- migraine, with and without aura
- tension headache
- cluster headache
- other rare primary headaches
Table: different types of primary form
|Other rare primary headaches|
Are secondary headaches a symptom of the disease?
Yes, a headache is a manifestation of another disease or health problem.
The secondary form is also referred to as symptomatic.
Symptom = sign.
The basis of the headache is some organic disorder or damage to the structure of the brain. Subsequently, pain may radiate to the head from another nearby area. An example is cephalea and vertigo in addition to cervical spine pain.
In this case, the headache may be a manifestation of a non-serious condition. However, it is also a disease that threatens a person's health or life.
The most serious cases can end in death.
For this reason, a thorough examination is necessary.
The general rule is true:
The risk increases as we age.
Especially if, the first headache after the age of 40 is present.
Subsequently, if the problem occurs after an injury.
Another type is also pain in common viral diseases that affect the upper respiratory tract, sinusitis, such as influenza. In addition, the intensity can be escalated by an increase in body temperature and fever.
This form of pain may be the only manifestation of a newly-occurring disease.
1. Headache after trauma (injury)
Just as the name suggests, the difficulty is caused by an accident. In addition to head injuries, it is necessary to think about damage to the cervical spine.
With impacts, physical force and energy is transferred from the head to the neck, which can also cause changes in the area.
- contusion of the brain, with head trauma there is also bruising of the nervous tissue
- post-traumatic bleeding in the skull = intracranial haemorrhage, such as epidural or subdural
2. Cerebrovascular diseases
A stroke, also called a cerebrovascular accident (CVA), a cerebrovascular insult (CVI), or a brain attack, may have the character of a cerebral infarction or haemorrhage.
Ischemic stroke/transient ischemic attack (TIA).
A cerebral infarction is a non-clotting of brain cells that occurs due to thrombosis or embolism.
Thrombosis has its basis in damage to the vessel wall, even as a consequence of atherosclerosis. Vascular changes gradually lead to partial, even complete, restriction of blood flow to nerve cells.
Embolism occurs after a blood clot is introduced into the blood vessels of the brain from other parts of the human body, most commonly from the heart in cardiac arrhythmias (such as atrial fibrillation, or A-Fib) or in heart valve disease.
In this case, headache may also be a symptom. However, in the foreground there are neurological difficulties such as impaired limb mobility, speech impairment and others.
Hemorrhagic (i.e. bleeding) stroke.
Bleeding in the intracranial area is very dangerous.
Here is one way to image what goes on:
Blood leaks outside the blood vessels >
thereby oppressing surrounding parts of the brain, nearby nerve cells >
as the cerebral part of the skull is closed >
the pressure inside the skull increases >
and thus damages the nerve tissue again >
swelling of the brain occurs in addition to all of the above >
the whole situation is deteriorating and collapsing.
Therefore, when red flags occur, an immediate examination is necessary to reveal the cause of the development of acute and intense headaches.
In this case, the rule is:
Time = brain.
There are several types of bleeding:
- subarachnoid haemorrhage (SAH)
- overwhelmingly sharp pain - thunderclap headache
- common brain aneurysm rupture - vascular aneurysm
- difficulties occurring in parallel:
- back of the neck stiffens
- and others
- can occur after demanding physical activity, especially when bending forward or after sex
- intracerebral haemorrhage (ICH)
- acute headache
- nausea and vomiting
- neurological symptoms according to the area of bleeding
- cerebellar haemorrhage
- acute headache
- back of the neck stiffens
- postural and mobility problems
In both types of stroke, the course depends on the extent and localization of the acute condition.
More important information in the article:
Headache: Sometimes it is harmless, other times it indicates a serious problem.
3. High or low blood pressure
Cephalea commonly occurs during hypertension, i.e. high blood pressure. Each person is different and also tolerates the increase in blood pressure differently.
It is reported that more severe headache occurs when the diastolic (heart) blood pressure increases above a TKd of 100-110 mmHg.
Of course, it can be added even with a less significant increase.
Watch out for the co-occurrence of headaches and nosebleeds - blood pressure control is needed. Mostly recurrent epistaxis (nosebleeds) occurs when blood pressure rises.
Untreated hypertension is particularly risky, due to dangerous complications such as stroke or heart attack and even death.
Headaches are also encountered by people who, on the contrary, have too low blood pressure.
4. Headache and cervical spine pain
These two problems occur together very often. Pain spreads from the cervical spine through the nape of the neck, back of the head.
You know the one, the tight neck muscles, the neck, the jerky movement, the wrong turn of the head or the draft or the blowing of the cold air conditioner.
- after neck strain
- after a sharp head movement
- workload - monotonous position, bending over, behind the computer
- bad position during sleep
- having a cold
The pain can spread from the neck, go across the back of the head, down one side of the head, into the temples, behind the ear and into the eye.
In addition, dizziness, nausea, upset stomach, a feeling of vomiting and other discomforts may be associated with it.
When researching the subject, you will also come across names such as:
cervical vertigo, when dizziness is present and
cervicogenic pain = pain coming from the neck.
5. Brain tumours
Headache is one of the common symptoms of brain cancer. It occurs in 60-70% of cases.
However, it may not be permanent and worsens as the tumour grows. In this case, it may be benign, i.e. benign, but as it gradually increases in size, it behaves like a malignant tumour.
The cerebral part of the skull is closed. Even if the tumour is well circumscribed and does not grow into the surrounding structures, pressure will cause damage.
With very slow tumour growth, pain may not occur.
Of course, malignancy is always a more serious condition.
The tumour may arise primarily from nerve cells and structures in the brain, but metastasis to the brain is also common.
Metastases are tumor cells transferred from site "A" to another site "B" in the human body.
6. Brain infections
Or also neuroinfections arise on the basis of the penetration of a microorganism into the brain tissue. The route of transmission may be blood or other nearby infection to the brain.
These are serious conditions that are accompanied by a number of symptoms and complications.
Some are infectious, others are not. They are caused by viruses (herpesviruses), bacteria (meningococcus, streptococcus, staphylococcus, pneumococcus, E. Coli and others).
The course is mostly sudden, abrupt, dramatic with worsening within 24 hours.
The intensity is high and the pain is severe.
Fever, petechiae, fatigue, drowsiness, confusion, disorientation, deeper disturbance of consciousness, even unconsciousness are associated.
In infections of this type, it is also possible to hear the term meningeal irritation, which includes stiffening (opposition) of the neck and immobility of the neck, head and sensitivity to light - photophobia.
7. Other forms
That's not all.
There are also other forms. Here are some of them:
- liquor hypotension - decrease in cerebrospinal fluid pressure, e.g. after a puncture of the liquor, after an epidural
- aortic disease and carotid artery disease
- inflammation of the upper respiratory tract and sinuses - sinusitis
- temporo-mandibular joint disorder
- nerve inflammation and neuralgia, trigeminal neuralgia
- arteritis temporalis - inflammation of the temporal arteries, Horton's disease
- hormonal changes
- sleep apnoea
- Lyme boreliosis
- eye disorders, when headache and eye problems occur together
- dehydration, for example in diarrhoeal disease, when abdominal pain, nausea or vomiting are also present
- after alcohol cinsumption
- after smoking or drinking coffee
- carbon monoxide and carbon monoxide poisoning
- mental disorders
Headache is common in women
The same goes for migraine, too. Why?
16-18% of women complain of migraines. In men, the figure is around 4-5%.
One of the provoking factors is a hormonal change. Fluctuations in estrogen levels, ovulation, menstruation (premenstrual syndrome), menopause or pregnancy.
A few tips that generally help:
- eat less food but more portions per day (5 or 6)
- avoid foods and drinks with higher sugar and fat content
- fruit instead of sweets and sweetened drinks
- more than one yoghurt a day can be a lot, because lactose affects the level of the hormone estrogen
- no alcohol or caffeine
- more fibre in the diet
Of course, other common conditions are also present. Cervical spine, pain from draughts, in the morning after waking up from a bad sleeping position or with increased mental and physical exertion.
If other symptoms appear, such as tinnitus, upset stomach or pressure in the eyes, it is better to see a doctor.
Headaches in children - take them seriously
Cephalea in children is rather common.
Migraine is among the possible causes as early as the age of 10, especially in puberty.
Tired, mentally exhausted and stressed children will also complain of pain. The latter comes on with colds, flu, sinusitis, otitis media.
Pain all over the body, headache, chills, shivering, fatigue = rise in body temperature up to fever. These ailments occur together almost always.
A sedentary lifestyle is bad for children. It is associated with spinal problems and, like in adults, may be behind headaches.
Even in this age group, the following is true: Pay attention to warning signs.
- Scoliosis in children or in adulthood: what causes, manifestations and treatment?
- Lordosis in children and adults: why does a morbid curvature of the back arise?
- Kyphosis, hyperkyphosis and round back: What are its causes, manifestations, treatment?
- Scheuermann's disease, juvenile kyphosis: what causes and symptoms does it have?
How to get rid of headaches?
If we know the cause, will begin to get an answer...
However, from the preceding text, it can be seen that the issues surrounding pain are very complex. And so, too, is the treatment.
It is important to bear in mind that it is necessary to follow a long-term therapy of the underlying disease, which provokes various difficulties, among them headache. Consequently, if you know about the provoking factors that trigger the difficulties, you need to limit them.
As always: a healthy lifestyle, sufficient and appropriate physical activity, a rational diet and regimen measures in acute deterioration. Possibly rehabilitation, massage or spa treatment.
Whether it is migraine or high blood pressure. It applies in both cases (and others).
Those who are lucky are those who are helped by common (even over-the-counter) pain killers (analgesics, e.g. Ibalgin, Paralen and others). Others will have to seek help from a specialist.
You will come across recommendations of grandmotherly advice or alternative products, homeopathics, as well as the use of herbs and teas.
Believe it or not, however, with uncertainty about whether it is a migraine and with the appearance of warning red flags,... no amount of folk healing will help.
Time is brain = early recognition of symptoms with expert diagnosis and early targeted treatment > can save health, minimize brain damage, prevent permanent disability to death.
The diagnosis is based on the above-mentioned medical history (personal, family, medication), neurological examination and other special examinations, which include imaging methods such as:
- blood collection
- liquor analysis
- USG (carotids and other blood vessels)
- physicians from specialties may collaborate
- internal specialist
Diseases with symptom "Headache"
- Anaphylactic shock
- Bleeding in the brain
- Burnout Syndrome - Burn-out
- Carotid artery stenosis
- Cerebrovascular diseases
- Congenital Cardiac Defects
- Coronavirus - COVID-19
- Cushing's syndrome
- Cytomegalovirus infection
- Diabetic retinopathy
- Dry eye syndrome
- Edema of the brain - swelling
- Fabry disease
- Facet joint syndrome
- Heart valve disease
- High Blood Pressure
- Hypertensive crisis
- Infectious Mononucleosis
- Irritable bowel syndrome
- Juvenile idiopathic arthritis
- Kyphosis hyperkyphosis
- Lyme disease
- Mammary Gland Inflammation
- Meniere's disease
- Middle Ear Infection
- Monkeypox - Monkeypox
- Overlap syndrome and mixed connective tissue disease
- Polycystic Ovary Syndrome
- Pulmonary hypertension
- Rheumatic Fever
- Rheumatoid Arthritis
- Shock - State of shock
- Spinal Cord Injuries
- Spinal Disc Herniation
- Spinal Stenosis
- Systemic Lupus Erythematosus
- The common cold
- Tick-borne encephalitis
- Tuberculous meningitis
- Tumours of the spine and the spinal cord
- Typhoid fever
- Vertebrogenic Pain Syndrome
- Coccygeal pain
- Histamine intolerance
- Kawasaki disease
- Sjögren's syndrome
- Tourette syndrome
- Yellow Fever