Headache (patient information)

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 * Associate Editor(s)-In-Chief: Jinhui Wu, M.D.

Overview
Headache is a term used to describe as pain in the head or upper neck. It is one of the most common locations of pain in the body. Headaches have numerous causes, such as brain tumors, brain infection, anxiety, arthritis in neck or spine, depression, some drugs, alcohol and environmental changes. Headaches can be divided into two types: primary headaches and second headaches. Primary headaches refer to headaches not associating with any stuctural problem in the head or neck, including migraine, tension, and cluster headaches. Secondary headaches are those that are due to an underlying stuctural problem in the head or neck, such as brain tumor, stroke, or brain infection. Except for headache, secondary headaches include other symptoms caused by the diseases, such as fever, hemiplegia, nausea and vomiting. Meidcal history, physical examination, neurological evaluation and head images may help find the cause of headache. Treatment opinion of headache depends on the causes, including biofeedback training, relaxation training and medications. The prognosis of headache depends on the underlying causes. Headache may be an early sign of some severe brain diseases.

What are the symptoms of Headache?
There are two kinds of headache: primary headaches and second headaches. Primary headaches refer to headaches not associating with any stuctural problem in the head or neck, including migraine, tension, and cluster headaches, and a variety of other less common types of headache. Secondary headaches are those that are due to an underlying stuctural problem in the head or neck, such as brain tumor, stroke, or brain infection. Except for headache, secondary headaches include other symptoms caused by the diseases.
 * Symptoms in primary headaches include:
 * Some headaches onset without aura. Certain food, emotion changes or environmental chages may be the auras for other headaches.
 * A pain that begins in the back of the head and upper neck, as a tightness or pressure.
 * The pain is usually mild and bilateral
 * Not accompanied with nausea or vomiting
 * Usually occur sporadically
 * No function damage


 * Symptoms in secondary headaches depend on the underlying cause. Except for headache, there may be other symptoms such as the following.
 * Headache may be continuing.
 * Fever
 * Hemiplegia
 * Nausea and vomiting
 * Diplopia
 * Anepia

Who is at highest risk?

 * Brain tumors
 * Brain infection
 * Intracranial hypertension
 * Anxiety
 * Arthritis in neck or spine
 * Degenerative bone or disk disease in the neck or spine
 * Depression
 * Temporomandibular joint disorders
 * Drugs, such as nitrates
 * Alcohol
 * Environmental changes, such as changes in barometric pressure and altitude, inclement weather, or high winds.

What causes Headache?
Headache is a kind of symptom, the most important thing is to make the underlying causes clear.
 * Meidcal history, the characteristics of the patient's headache.
 * Physical examination and neurological evaluation.
 * Eye examination: It is very useful to identify underlying problem in the brain.
 * Blood tests: Blood tests include complete blood count, liver, and kidney function tests. The results of the various lab tests may provide clues to detect some secondary headaches that can cause coma.
 * Head imaging studies such as CT and MRI: These images can be used to detect the structural problems in the brain.
 * Electroencephalography (EEG): This test can demonstrate the electrical activity in the brain and be helpful for the diagnosis.

When to seek urgent medical care?
Headache is just a symptom. It is necessary to indentify the underlying causes. So, go to see your doctor when you show this symptom. If you feel the following symptoms, go to the emergency department as soon as possible.
 * Sudden sever headache
 * sudden headache associated with a stiff neck
 * Headache accompanying with nausea or vomiting
 * Headache accompanying with fever, convulsions, or confusion or loss of consciousness
 * Headache accompanying with pain in the eye or ear
 * Headaches following trauma to the head
 * Persistent headache in a person who was previously headache free
 * Recurring headache in children

Treatment options
Treatment opinion depends on the causes of headache.
 * Discontinue the drugs that cause headache, such as nitrates.
 * Avoidance certain foods from the diet that cause your headache
 * Regular exercise, such as swimming or vigorous walking, may help control some kind of headaches.
 * Biofeedback training
 * Relaxation training
 * Drug therapy, such as sumatriptan, propranolol hydrochloride, methysergide maleate, ergotamine tartrate, amitriptyline, valproic acid, or verapamil. These drugs can reduce the frequency and severity of headaches and improve life quality of the patients.
 * Treatment of underlying causes, such as surgery for hemorrhagic stroke, surgery or radiation therapy or chemotherapy for brain tumor, antibiotics for brain infections.

Diseases with similar symptoms

 * Dizziness
 * Migraine

Where to find medical care for Headache?
Directions to Hospitals Treating Headache

Prevention of Headache

 * Avoidance of certain food that may cause headache to happen.
 * Avoidance of alcohol abuse
 * Avoidance head trauma

What to expect (Outlook/Prognosis)?
The prognosis of headache depends on:
 * Underlying causes