Headaches

Headaches are the most common reason for patients to visit their doctors. Areas of the scalp, face, eyes, mouth, throat, and head can all be involved during a headache. Studies show that almost 90% of men and 95% of women have at least one headache every year.

"Primary" headaches (headaches that are not the result of an underlying medical problem) comprise 90% percent of all headaches. These fall into three categories:

Migraine (or Vascular) is actually a neurological disease whose symptoms include a very painful headache. During a Migraine attack, all of the patient's senses become highly sensitive. Migraines often occur during specific types of weather patterns including high temperature, high humidity and rapid changes in barometric pressure. They occur most frequently in women and affect 12-15% of the world population. Research has shown that migraines are hereditary and can occur in a child as young as two, although it is more common to see onset after the age of six.

Migraines are often brought on by certain "triggers" that may include: bright lights, alcohol (especially red wines and scotch), chocolate, aged cheese, MSG, fish, nitrates, and even second-hand smoke.

Migraines are not just "bad headaches." In their severest form, they can in fact, be a life threatening disease. Migraines are NOT a psychological problem, although their have been many myths associated with the disease causing people to believe they are. They can play a significant role, however, in changing a person's lifestyle (such as being perceived as being anti-social, having problems keeping a job due to attendance problems) and may lead to secondary psychological problems.

Tension or Tension Type Headaches are the most common form of headaches. They can be episodic or chronic. Frequently the same patients that experience migraines, experience tension headaches as well.

Cluster Headaches
Cluster Headaches are considered the most painful of all headaches. The pain is even more relentless and intense than reported in migraines. Cluster Headaches affect more men than women, but overall affect only 0.1% of the population. "Cluster" comes from the pattern of these headaches. They tend to occur in cluster periods of six to eight weeks per year. "Episodic" Cluster headaches may occur every one or two years or they may occur once in a lifetime.

"Chronic" Cluster headaches are one that occur on a much more frequent basis. Patients report them as frequently as every day. Only a small percentage of all Cluster headache sufferers have this form of the disorder.

"Secondary" headaches (headaches that are attributable to another medical problem) may come from problems such as allergies or sinus or more serious conditions such as brain tumors or aneurysms. Patients who are prone to headaches may find that there are stresses that tend to "trigger" the headaches. No persistent headache and/or recurring headache should be ignored. Cat Scans (also known as CT Scans) which provide images of soft tissue, bone, and blood vessels and MRI's (link to MRI test) are commonly used to evaluate the cause of persistent headaches.

Symptoms

Although many headaches can be treated with non-prescription pain relievers, patients should see a doctor if they have any of the following symptoms:

URGENT

Have a stiff neck or fever with headache
Have slurred speech, dizziness, weakness, numbness or tingling with headache
Have confusion or drowsiness with headache
Have fever, shortness of breath and sudden problems with ears, nose, throat, or eyes

NON-URGENT

When non-prescription medications take more than the recommended dose to be effective
Taking pain medications on an almost daily basis
Headaches several times a week
Headaches that begin after age 50
Headaches are accompanied by vomiting
Exercise, coughing, bending, sneezing or sexual activity brings on headaches
Headaches began with a head injury, but continue after their injuries appear to have healed
Severe headaches that occur monthly, associated with a woman's menstrual cycle

MIGRAINE SYMPTOMS

Migraine can occur with or without an aura. A migraine with an aura means that the patient experiences visual disturbances or other warnings either before or during the migraine. They account for about 15% of all migraines. The aura can last up to one hour and may or may not be accompanied by a headache. Persistent visual changes could be related to a more serious problem and should be investigated more thoroughly. Migraines without an aura are more common. Other underlying causes must be ruled out to ensure there is not a more serious condition that is causing the headaches.

TENSION OR TENSION TYPE HEADACHE SYMPTOMS

Episodic Tension-Type headaches are sometimes described as feeling like a tight band around the head; these headaches do not usually cause a throbbing pain. The pain is often described as moderate and patients are able to function in spite of a tension headache.

Chronic Tension-Type headaches have the same symptoms as the episodic tension headache but they occur much more frequently. Patients usually report symptoms more than 15 days per month and sometimes even daily headaches. Patients can be sensitive to light and/or sound as well as experience nausea as part of the headache.

Chronic Daily headaches are a problem for up to five percent of the US population. Typically, they do not have constant pain during the day, instead they report that it "comes and goes." Occasionally the pain can become severe enough to get in the way of daily activities. Research has shown that many chronic headache patients may have started with migraines and progressed to daily headache pain. Because of the chronic pain, many patients take daily doses of pain medication and eventually end up with a "rebound" headache from the overuse of the medication.

CLUSTER HEADACHE SYMPTOMS

Patients report severe pain behind one of their eyes that feels like constant pressure. Their eye may tear and even become droopy. The duration can last anywhere from a few minutes to three hours but most commonly lasts about 45 - 90 minutes.

Treatment

The treatment of headaches should be approached cautiously. There are many medications available depending on the cause and the type of headache. The doctor will need to evaluate and monitor the use of all medications, prescription and over-the-counter, to make sure that the patient does not experience rebound headaches and/or mask other conditions or problems.

The doctor may have the patient keep a journal to help determine if there is a trigger for the headaches. In the case of both migraine and cluster headaches, there are drugs that the patient can take when they feel a headache starting that may stop the progression and/or lessen the severity of the headache. Some medications can also be taken on a daily basis to prevent headaches from occurring.

Some patients are also having success with non-medication treatments for certain types of headaches. Techniques such as visual imagery, relaxation therapy and biofeedback have been helpful for some patients. It is important that the patient and doctor determine the techniques that work best for the patient's type of headaches and the lifestyle.

Very often, a multi-faceted approach to treatment, especially for Migraine patients is recommended. This would cover: Prevention, Managing Triggers, Controlling Acute Attacks, and Pain Management.

Support

National Headache Foundation
http://www.headaches.org
428 W. St. James Place, 2nd Floor
Chicago, Illinois 60614-2750
888-NHF-5552

"The National Headache Foundation is a nonprofit organization dedicated to serving headache sufferers, their families and the healthcare practitioners who treat them; promoting research into headache causes and treatments; and educating the public to the fact that headaches are a legitimate biological disease and sufferers should receive understanding and continuity of care."

Local Support Group
Mercy Medical Center
1320 Mercy Drive NW
Canton, Ohio
Ambulatory Care Center, Auditorium
Contact: Cindy Hickey at 330-489-1333
Meets: The 2nd Wednesday of every other month 6:30 PM

American Council for Headache Education
http://www.achenet.org/
19 Mantua Road
Mt. Royal, New Jersey 08061
856-423-0258

"The American Council for Headache Education(ACHE) is a nonprofit patient-health professional partnership dedicated to advancing the treatment and management of headache and to raising the public awareness of headache as a valid, biologically based illness."

The National Migraine Association
http://www.migraines.org
M.A.G.N.U.M., Inc. (Migraine Awareness Group: A National Understanding for Migraineurs)
Washington, DC Office
113 South Saint Asaph Street
Suite 100
Alexandria, Virginia 22314
(703) 739-9384
(703) 739-2432 (fax)
magnumnonprofit@hotmail.com

"M.A.G.N.U.M. was created to bring public awareness, utilizing the electronic, print and artistic mediums, to the fact that Migraine is a true biologic neurological disease, to assist Migraine sufferers, their families, and coworkers, and to help improve the quality of life of Migraine and head-pain sufferers worldwide." This website helps to separate migraine myths from reality and provides easy to understand information.