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By Mitalee Kar
Numerous diseases and illnesses have plagued humans and humanity since time immemorial. Headache has been a common problem since the earliest days of the mankind and has affected many since the Neolithic era.
Headaches can be mainly of two types - primary and secondary. A primary headache isn't a symptom of an underlying disease. One common type of primary headache is Migraine. The hemicranial headache is often of throbbing quality and can be associated with nausea, abdominal upset, vomiting, and irritation to sound light and strong smells. These often have identifiable stressors or triggers which we call as migraine triggers. It is more common in women and in urban population. It often causes considerable loss of quality of life due to immediate effect of loss of concentration in the work at hand.
A secondary headache is essentially a symptom of a underlying disease that can activate the pain-sensitive nerves of the head. Any number of conditions — varying greatly in severity — may cause secondary headaches, the common causes being blood clot (venous thrombosis) within the brain, Encephalitis (brain inflammation), Influenza (flu) and other febrile (fever) illnesses, brain tumor or aneurysm, dental problems, rhinitis or middle ear infection just to name a few. The secondary causes of headache often have features that resemble migraine, tension-type headache, or a trigeminal autonomic cephalgia. Caution must be exercised and warning signs and symptoms of secondary headache must be evaluated.
A headache history is the most important aspect of the evaluation of a patient presenting with headache; and eliciting worrisome features with directed questioning is necessary. The history must be taken without assuming that key features will be volunteered by the patient. Brain MRI is the imaging procedure of choice when evaluating intracranial or neurovascular causes of headache. Other than the detection of skull fracture or acute intracranial blood, the use of CT in the evaluation of secondary headaches should be restricted, especially in children.
It is always advisable to not keep popping the OTC painkillers for your headache but to visit a qualified doctor and get yourself properly evaluated.
Dr Mitalee Kar is a neurologist.
(DISCLAIMER: The views expressed are the author’s own and have nothing to do with OTV’s charter or views. OTV does not assume any responsibility or liability for the same.)
