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Headache

Overview

Headache is a common condition presenting with pain or discomfort in the head and neck region. Most headaches are vascular (blood vessel-related) in nature and typically not life-threatening. Some headaches may indicate a serious medical problem and require immediate attention.

The symptoms vary with the type of headache, but common features include:

  • Dull, aching, or throbbing pain in the head or neck
  • Pain that may be one-sided (migraine, cluster headache) or generalised (tension headache)
  • Associated symptoms such as nausea, vomiting, and light or sound sensitivity (common in migraine)
  • Nasal congestion or facial pain (sinus headaches)
  • Severe, sudden, sharp pain (warning sign of serious cause)

Most common causes include:

  • Tension-type headache
  • Sinus headache
  • Migraine
  • Rebound headache (due to overuse of pain medication)
  • Cluster headache
  • Idiopathic intracranial hypertension (increased brain pressure)
  • Mixed headache as in combination of tension-type headache and migraine

 

Less common causes are:

  • Mass lesion in the brain like tumour or granuloma
  • Head injury
  • Intracranial or subdural haemorrhage
  • Meningitis/ encephalitis/ other CNS infections
  • Raised intracranial pressure due to brain swelling
  • Vasculitis/ other inflammatory disorders of CNS

Doctors diagnose headaches mainly through:

  • History and clinical examination: identifying triggers, duration, and type of pain
  • Fundus examination: to check for signs of raised intracranial pressure
  • MRI/ CT head: when a secondary or serious cause is suspected

Headache treatment depends on the underlying cause:

  • Supportive care: rest, pain abortive medications like paracetamol, naproxen, depending on the cause of headache
  • Prophylactic medication: on a regular basis to prevent frequent migraines or chronic headaches
  • Specific treatment: CSF drainage/removal of lesion depending on aetiology
  • Lifestyle changes and avoidance of precipitating factors: stress management, good sleep, regular meals, hydration, and avoiding triggers like excess caffeine
  • Botulinum injection in specific cases

Headaches that require immediate medical attention are:

  • Acute severe headache which has never happened in past (acute thunderclap headache)
  • Change in character/ severity/ location of headache
  • Headache associated with focal neurological signs like weakness/ visual disturbances
  • Headache along with loss of consciousness/ seizures
  • New onset headache in the elderly
  • Headache worsening while leaning forward or straining

While not all headaches can be prevented, steps can help reduce frequency and severity:

  • Maintain regular sleep and eating patterns
  • Stay well-hydrated
  • Limit caffeine and alcohol intake
  • Avoid medication overuse
  • Manage stress through relaxation techniques or therapy

For diagnosis and management of headaches, consult a Neurologist (specialist in brain and nerve disorders).

Disclaimer:

The information in this Health Library is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare professional with any questions about a medical condition or before starting any treatment. Use of this site and its content does not establish a doctor–patient relationship. In case of a medical emergency, call your local emergency number or visit the nearest emergency facility immediately.