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A headache is one of the most common ailments. Many people can experience a headache at some point in their life. Headaches can occur as a result of many conditions whether serious or not. The International Classification of Headache Disorders (ICHD) identifies various types of headaches and classifies them in 3 principal groups: a primary headache, secondary headaches, and cranial neuralgias.
• Primary headaches include a tension headache, migraine, cluster headache
• Secondary headaches are due to other conditions such as trauma, infection, vascular disorders, the effects of medications, the effects of recreational drugs and other conditions
• Cranial neuralgias include trigeminal neuralgia and other conditions
It is important to identify the type of a headache in order to receive appropriate treatment. Symptoms vary according to the type of headaches. The pain can be throbbing, pulsating, sharp, stabbing, pressure-like etc. In can be mild to severe. It can start suddenly or gradually. It can occur on one side or both sides of the head. It can be associated with other symptoms, such as nausea, vomiting, sensitivity to light or noise, visual disturbances, weakness, numbness, dizziness, balance problems, etc. The duration can be extremely short (seconds or minutes), or it can be longer (hours or days). The frequency can also vary. Some people experience a headache rarely but others can have it every week up to every day. Some types of headaches can be seasonal.
Patients with headaches should visit a Neurologist in order to find out the exact cause of their headaches and receive appropriate treatment.
Headaches can often be treated successfully without the need for further investigations but sometimes there are symptoms or signs that can indicate a potentially serious underlying disorder and necessitate investigations. These are called red flags and include:
• Sudden or a thunderclap headache
• A headache after 50 years of age
• Headaches triggered by bending, coughing or sneezing.
• A headache with signs of systemic illness (fever, stiff neck, rash)
• Focal neurologic signs or symptoms of disease
• Papilledema (swelling at the back of the eyes)
• A headache subsequent to head trauma
• A new-onset headache in a patient with an underlying medical condition
• Headaches increasing in frequency and severity
The treatment depends on the diagnosis and can involve acute and/or prophylactic treatment. It is often useful to keep a headache diary to make sure the treatment is effective and the headaches are improving. Other treatment options depend on the type of headaches. In conclusion, most headaches are benign and resolve spontaneously or after common analgesics intake.