Headache

Headache is one of the most common health complaints, and most headaches are not caused by any serious disease. They are usually linked to tension, migraine, poor sleep, eye strain or sinus problems. Rarely, a headache can be a sign of a serious problem in the brain, such as bleeding, infection or a tumour, so it is important to know the warning signs.

Symptoms

Headaches differ in their pattern. Common types and their usual features are:

• Tension-type headache: a dull, tight or band-like pressure around the head, often linked to stress, poor posture or tiredness
• Migraine: throbbing pain, often on one side, with nausea and discomfort from light or sound
• Cluster headache: very severe pain around one eye, coming in bouts, with a watering eye and blocked nose on the same side
• Sinus headache: pain over the forehead and cheeks with a cold or blocked nose
• Medication-overuse headache: near-daily headache caused by taking pain relievers too often
• Secondary headache: headache caused by another condition, such as infection, injury or a problem inside the skull

Causes

Common triggers include stress, poor sleep, skipped meals, not drinking enough water, long hours on screens, uncorrected eyesight, sinus infection, neck strain, and too much tea, coffee or alcohol. Less common but more serious causes include bleeding in or around the brain, brain tumour, meningitis, build-up of fluid in the brain (hydrocephalus), raised pressure inside the skull and blood clots in the veins of the brain.

Diagnosis

In most cases the diagnosis is made from a detailed history and a careful neurological examination, and no scan is needed. A headache diary noting the timing, triggers and medicines taken is very useful. A CT or MRI scan of the brain is advised when there are warning features, an abnormal examination, or a clear change in the usual headache pattern.

Treatment

Most headaches are treated with lifestyle changes and medicines. Regular sleep, regular meals, enough water, managing stress, regular exercise and limiting screen time help many people. Simple pain relievers can be used for occasional headaches, but they should not be taken on more than a few days a week, as overuse can itself cause daily headaches. For frequent migraine or other recurring headaches, a doctor may advise preventive medicines.

A neurosurgeon's role is to evaluate the headache, rule out serious causes and treat conditions that need surgery, such as a brain tumour, bleeding or hydrocephalus. Only a small number of patients need surgery.

When to Seek Urgent Care

• A sudden, very severe headache that reaches its peak within seconds to a minute
• Headache with fever, stiff neck, rash or confusion
• Headache with weakness, numbness, difficulty speaking, loss of vision or double vision
• Headache after a head injury, especially with vomiting or drowsiness
• Headache with a seizure or fainting
• A new headache after the age of 50, or one that keeps getting worse over days or weeks
• Headache that wakes you from sleep or worsens on coughing or straining, with repeated vomiting
• A new headache during pregnancy, or in someone with cancer or low immunity

If you notice any of these, go to the nearest emergency immediately.

If your headaches are frequent, severe or changing in pattern, consult Dr. Prashant Sharma for a careful evaluation.

Related Conditions

• Migraine
• Nerve Pain (Neuropathic Pain)
• Paralysis (Weakness of Limbs)
• Unconsciousness (Loss of Consciousness)
• All Neurological Treatment ›