The headache is a pain or discomfort in the face, neck or scalp. 
A severe headache is very rare. 
Most people with this disorder get better at making lifestyle changes and learning ways to relax and take medications.

 

Causes

Tension-type headache

Girl with headaches

The most common type of headache is caused by muscle contractures in the shoulders, neck, forehead and jaw. 
This type of pain is called tension headache
Causes can be: stress, depression , anxietyhead trauma or poor posture . 
Many people are prone to headaches from study stress, from tiredness, from office computer work. 
Staying very focused for hours without a break and maintaining wrong postures can contribute to the development of a stress headache.
Tension headache is of medium intensity, it is felt on both sides of the head like a helmet. It often starts at the nape of the neck and spreads forward. 
The discomfort can last from a few hours to a few days and is not aggravated by normal daily physical activity (walking, climbing stairs, etc.). 
The pain may be deaf or sharp, as if the chin is tense or painful. The shoulders, neck or jaw may have muscle contractures.

 

Headache of cervical origin (cervicogenic headache)

Many patients have a pain that radiates from the neck to the nape of the neck, in certain cases it can reach the front and behind the eye. 
Headache of cervical origin is often accompanied by dizziness or vertigo . 
The cause may be poor posture, stress, anxiety or trauma. 
The most appropriate treatment is a combination of massage therapy with the Mckenzie method .

 

Migraine

migraine is a severe headache that usually occurs along with other symptoms such as blurred vision or nausea . 
The pain can be excruciating, hammering or sharp. It usually starts on one side of the head, although it can spread on both sides. 
There may be an “aura” (a group of warning symptoms that begin before headaches). Pain usually worsens with movement. 
These headaches can be triggered by foods such as chocolate or cheese, even caffeine intake, lack of sleep and alcohol can cause a migraine. 
The pain can affect everyone, teenagers, adults and seniors, can last from a few hours to 2/3 consecutive days.

Night Migraine
Many migraine sufferers may experience seizures during the night or in the early hours of the morning. 
This headache often causes the patient to awaken. 
Scientific studies suggest that these attacks are related to neurotransmitter changes in the brain during sleep.

Pregnancy and Migraine
About 80% of women suffering from migraine  do not have the attacks at the end of the third month of pregnancy until birth. 
It is believed that the cause is hormonal stability.

 

Exercise cafes

If the headache starts quickly and unexpectedly with violent physical exertion, consult a physician immediately. 
It can be a benign headache, but it can also be a subarachnoid hemorrhage, which can result in double vision , weakness and loss of sensitivity. 
When we contract the neck muscles during rigorous physical activity, stress accumulates in the head, causing a headache. 
The pain is pulsatile and affects both sides of the head. 
If it lasts for more than a few minutes (can last for a few hours), an anti-inflammatory medicine should relieve the pain. 
We also need to know that dehydrationcan cause headaches that appear during exercise (for example, running). 
If the headache usually occurs during sexual activity or exercise, the doctor may recommend an anti-inflammatory like Alivium about one hour before exercise.

 

Trigeminal Neuralgia

Trigeminal neuralgia is a chronic disease that causes a terrible pain in the face, along the course of the trigeminal nerve. 
This nerve carries the sensitivity of the face to the brain. 
Trigeminal neuralgia can cause excruciating pain attacks, even with mild facial stimulation, for example, brushing your teeth or putting on makeup. 
Generally, the problem is the contact between a normal blood vessel and the trigeminal nerve at the base of the brain. This contact puts pressure on the nerve and causes malfunction.

The symptoms are:

  • Light Pain Spikes
  • Episodes of severe pain similar to an electric shock in areas innervated by the trigeminal nerve, including the face, jaw, teeth, gums, lips or more rarely the eye and the  front .
  • Generally, only one side of the face is affected by neuralgia.

Doctors can effectively treat trigeminal neuralgia with medications, injections, or surgery.

 

Chronic headache

Individuals who have a chronic daily headache are considered among the most difficult patients by neurologists. 
The most effective treatment plan can predict a change in lifestyle. 
Due to several factors, many individuals with chronic headache try new drugs and alternative therapies , but some patients worsen rather than improve through overuse of medications. 
Chronic headache is not a diagnosis, the headache lasts for at least 15 days a month for a period longer than 3 months.

 

Tension headache in children

This is the most common type of primary headache in children, emotional factors are the most likely cause. Pain is described as diffuse and sometimes as a narrow band around the head. 
It usually does not cause nausea or vomiting. 
These headaches are almost always related to stressful situations in school, sports, family or are caused by excessive demands of parents. An interview with the child and parents is necessary to determine if the child is suffering from anxiety or depression.

 

Bruxism

Many people grind or clench their teeth day and night without being aware of what they are doing. 
The bruxism can be caused by dental malocclusion, stress or worries. 
Excessive muscle activity sometimes causes headaches and muscle spasms. 
Signs and symptoms include: head and face pain, dental injuries, muscle fatigue , pain in the jaw and eventually bites on the tongue and the inside of the cheeks. 
The dentist can relieve the symptoms with a small appliance for the upper teeth that is used during sleep. 
In recent years, awareness that facial pain can be caused by the teeth has enabled many people to make an appropriate treatment.

 

Contact lenses headache

Contact lenses can cause headaches in the following cases:

  • People  who work or study  many hours with a computer develop tension in the muscles of the eyes and headaches, contact lenses can aggravate this discomfort because they tend to dry the eyes.
  • Dry eyes can cause hypersensitivity to light and causes eyes to squeeze, this behavior can add muscle tension.
  • A contact lens may be prescribed by a wrong eye examination because over time the sight changes. In this case it can cause excessive strain to see better and can cause headache.

 

Seasonal allergy

Seasonal allergy

The seasonal allergy or allergic rhinitis causes headaches in the area above the nose and radiates upward. 
The symptoms of the disease are usually  nasal congestion , sneezing and tears in the eyes . 
Headache occurs when the sinuses are irritated by certain foods or volatile allergens such as mold, pollen and grasses. 
An antihistamine such as Claritin should relieve headache, stopping the reaction to the allergen. 
If the allergic reaction is more severe, you should consult the doctor who can prescribe a nasal spray with cortisone .
Do not take a double dose of the medicine because it can cause headache rebound.

 

Sinusitis

The headache caused by   acute sinusitis is on the front of the head. 
When the paranasal sinuses or nasal cavities  become inflamed, usually due to an infection , they can cause pain. 
This headache is caused by swelling of the breasts behind the cheeks, nose and eyes. The pain tends to get worse when folding forward and waking up in the morning. 
Headaches caused by infection of the sinuses can be treated with antibiotics or antihistamines and decongestants.

 

Cough

Coughing headaches are an unusual type of headache triggered by sneezing and other stresses, such as when you blow your nose, laugh, cry, sing or evacuate stools.

Doctors divide headaches by coughing into two categories.

  • The primary coughing headache is generally harmless, limited episodes occur and improvement on its own. 
    The main cause is not known. 
    It is possible that increased head pressure (intracranial pressure) caused by coughing and other stresses may play a role in these headaches. 
    It starts suddenly with or after a cough or other exertion. 
    The duration varies from a few seconds to a few minutes, in some cases it may take up to 30 minutes. 
    The pain may be sharp, pangs or deafness. 
    It usually affects both sides of the head, especially on the back of the head. 
    It can be followed by a heavy, throbbing pain for several hours
  • The headaches caused by secondary coughing are more serious, it can be caused by problems within the brain. 
    Treatment of headaches caused by a secondary cough may include surgery.

 

Medications and headaches

Some medications have side effects, such as worsening headaches, for example:

  • Contraceptive Pills , There is scientific evidence that headache can be influenced by estrogen, this explains why women suffer more from migraine than men. 
    If a brand of contraceptive causes migraine for the first time or if it increases the frequency and the intensity, it is better to change brand after the medicalconsultation.
  • Analgesics – Some over-the-counter medications can cause recurring headache due to  abuse or  misuse .
  • Medications for diabetes – some of these medications can aggravate headaches.
  • For some women, hormone replacement therapy worsens the headache, researchers believe the fault lies in the small fluctuations of synthetic estrogen.
  • The alcohol  can also cause headaches, pain called post-hangover head because occurs the next day a person was drunk. 
    The pain is located in the front and top of the head, but lasts only a few hours or a day.

 

Medications and headache rebound

Headache from overuse of medications is one of the causes of frequent or daily headaches. 
It is caused by excess analgesics or triptan medicines for headaches or migraines, such as codeine, aspirin, advil, sumatriptan (imigran), zolmitriptan (Zomig), etc. 
Headache from overuse of analgesic drugs  is the third leading cause of headache after migraine and tension headache. About 1 person in 50 develops this symptom throughout life. It can occur at any age but is more common in people between 30 and 50 years.
Medications for headaches should be taken only once in a while, but if they are taken every day for at least a week they can cause pain. 
The symptoms are: morning pain soon after waking up, improvement after taking the medicine, but returns after a while, the discomfort remains all day and gets worse with physical or mental efforts. 
Other symptoms include: neck pain , anxiety , irritability, difficulty concentrating, depression and not sleeping well. 
Treatment consists of preventing the abuse of analgesics or triptans. 
After stopping the ingestion of analgesics or triptans, the headache becomes more intense and frequent for at least a week.
However, the frequency of headaches or migraines should gradually return to the level of prior to worsening.

 

Caffeine

Caffeine is a natural stimulant substance that is contained in certain foods and beverages: coffee, tea, Coca-Cola and some medicines  to relieve pain and migraine. 
Caffeine is a mild vasoconstrictor that has been proven to be useful in migraine medications. 
Due to a paradoxical phenomenon known as rebound headache, patients with headaches should refrain from overuse. 
Most people who suffer from headache can consume up to 200 mg per day in total. 
However, some patients with frequent headaches should completely avoid daily use. 
A cup of coffee contains between 60 and 100 mg of caffeine. 
The most common symptoms are headache, drowsiness and fatigue, the researchers found that these symptoms can be very serious and patients may even lose the job. 
Some medications used to treat headache  contain caffeine that should be considered in determining daily consumption.

 

Headaches over the weekend

Those who suffer from migraines on the weekend and especially Saturday and Sunday because they sleep many hours, should try to wake up at the same time as on other days. 
In addition, it is essential to get plenty of rest because fatigue can cause a headache. 
One factor that contributes to having a migraine or tension headache  over the weekend is stopping caffeine consumption. 
If a person during the week takes large amounts of substances that contain caffeine, headaches can occur during the weekend or during the holidays if you consume small amounts of this substance.

 

Premenstrual syndrome

Headache can be a symptom of premenstrual syndrome, in which case treatment is one of the most difficult. 
During the menstrual cycle, estrogen levels can decrease very rapidly. 
Researchers believe that hormonal fluctuation causes the dilation of blood vessels, causing a menstrual migraine. 
Up to 60 percent of migraines in women are related to the menstrual cycle. 
Regular sufferers of this syndrome may take an anti-inflammatory drug, such as ibuprofen, a day or two before the onset of menstrual symptoms. The drug helps capillary vasoconstriction and reduces the pain associated with menstrual headaches.

Symptoms
The symptoms of menstrual migraine are similar to migraine without aura, but morning pain is felt every 4 weeks. 
It starts as a throbbing headache, unilateral, accompanied by nausea, vomiting or sensitivity to light (photophobia) and sound. 
Many women experience pain two to three days before the pre-menstrual period. 
Generally, the headache is persistent and is often accompanied by other premenstrual symptoms, such as belly pain,cramping,and abdominal distension.

Treatment
Whoever feels headache before, during or immediately after menstruation can take non-steroidal anti-inflammatory drugs and triptans. 
Some patients benefit from antidepressants such as fluoxetine.

 

Head trauma

Headaches that begin after a head injury . 
Although it was a moderate blow and there was no loss of consciousness, it is necessary to go to the emergency room because the headaches can be caused by a concussion of the brain. 
Although most of these lesions are not serious, brain bruising and bleeding can cause loss of vision, confusion, and even death.

 

Infections

Encephalitis and meningitis are viral infections  that affect the brain, both of which can cause severe headaches. 
If the membrane surrounding the brain becomes inflamed, it is necessary to seek medical advice immediately. 
Any inflammation that occurs in the brain due to an infection can put tremendous strain on the nerves and can even be deadly. 
The fever can cause a headache, for example, in the case of the flu.

Bacterial infections (such as those caused by streptococci) can cause headaches. 
Women who have frequent urinary tract infections and take antibiotics like ciprofloxacin may worsen migraine. 
The generalized discomfort , stress, and muscle tension throughout the body can increase pressure on the temporal bone and headache. The doctor will probably prescribe antibiotics to treat the bacterial infection. 
People who have cancer or HIV/ AIDS and develop a new headache may have an infection in the brain, such as meningitis that should be promptly evaluated by a doctor. 
The herpes zoster around the eye or forehead can cause severe pain in the face as well as permanent damage to the eyes and loss of vision.

Corneal inflammation, eye lesions and acute glaucoma
A sudden and severe headache in addition to redness of the eyes can be caused by a number of diseases and is not life threatening, including corneal lesions and inflammation of the eyes. 
However, a form of acute glaucoma that causes a rapid increase in pressure on the optic nerve may suddenly occur with the same symptoms. If acute glaucoma is not treated it can lead to irreversible loss of vision. Therefore, in this case it will be necessary to go to the first aid .

 

The headaches that make you wake up
You need to worry if the headache gets worse for weeks or if you are present every morning when you wake up. This is the classic model for a mass that expands slowly. In this case, we need to do a medical examination and schedule an MRI.

 

Other types of headache:

  • Bald headache is a very painful headache that occurs several times a day for a few  months, so it can go through a similar period of time.
  • The patient suffers from headaches if he has a cold , flu or fever .
  • Temporal arteritis is a disease that causes swelling and inflammation of an artery that supplies blood to the temporal bone and the neck.

Rarely headaches can be the consequence of a more 
serious condition such as:

  • A tumor in the brain
  • Hydrocephalus
  • Arnold Syndrome
  • Blood vessel disorders and bleeding in the brain, such as arteriovenous malformation, cerebral aneurysm, or stroke
  • Hematoma subdural
  • Very high pressure .

 

Secondary headache

Secondary headache is a headache caused by a structural problem of the head or neck, there are several causes of secondary headache: brain hemorrhage, tumor, meningitis, encephalitis, etc.

What Causes Secondary Headaches?

Secondary headache is caused by an illness or injury that must be diagnosed and treated.

Head and neck trauma Head
injuries can cause bleeding between layers of tissue around the brain or inside the brain itself. 
Brain concussions in which head injuries occur without bleeding may be a symptom of a whiplash.

Blood vessel disorders of the head and neck:

  • Stroke or transient ischemic attack (TIA),
  • Arteriovenous malformations (AVM) can cause headaches,
  • Inflammation of the carotid artery,
  • Temporal arteritis (inflammation of the temporal artery).

Blood vessel problems in the brain:
Cerebral tumor: primary, which originated in the brain or cancer that was born in another organ
Seizures
Idiopathic intracranial hypertension, the pressure of the cerebrospinal fluid inside the spinal canal is very high.

 

Drugs and drugs (including drug abstinence).

Infections
Meningitis
Encephalitis
HIV / AIDS
Systemic infections (eg pneumonia or influenza)
Sinusitis

Changes in the body
High blood pressure ( hypertension )
Dehydration 
Hypothyroidism
Renal dialysis
Pregnancy, headaches are natural in pregnancy due to increased estrogen.

 

What are the tests for the diagnosis of secondary headaches?

The tests that may be useful to diagnose the pathology that causes the headaches are:

Blood tests
The blood tests are useful because they show the values that are changed in the case of certain diseases. 
For example, in the case of infection or inflammation, we can observe an increase in leukocyte count, erythrocyte sedimentation rate (ESR) and C – reactive protein (CRP).

Computed tomography of the head
Computed tomography (CT) is able to detect: bleeding, swelling and tumors.

Magnetic resonance imaging (MRI) of the head
MRI shows the anatomy of the brain and the meninges (the layers that cover the brain and spinal cord).

Lumbar puncture
Cerebrospinal fluid around the brain and spinal cord can be removed with a needle that is inserted into the lumbar spine.

Examination of the fluid may reveal an infection (such as meningitis caused by bacteria, viruses, or tuberculosis ) or bleeding.

 

When is it necessary to go to the doctor because of a headache?

A patient should see a doctor if the headache is:

    • The “strongest headache in your life.” It can be caused by subarachnoid hemorrhage caused by a ruptured brain aneurysm.
    • Different from the usual headaches.
    • Start suddenly or is aggravated by stress, coughing or sexual activity.
    • As a result of a head injury or fall.
    • Caused by changes in vision, speech, or behavior.
    • It disturbs work and quality of life.

 

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