Headache:

Types, Causes, Symptoms, Preventions and Treatments

(Continuation)

Secondary Headaches

Secondary headaches are headaches that are symptoms of another condition that stimulates the pain-sensitive nerves of the head.

Causes

There are a vast number of different conditions that can cause secondary headaches, ranging in severity from an alcohol-induced hangover to a brain tumor.

Headaches may be caused by problems elsewhere in the head or neck. Some of these are not harmful, such as cervicogenic headache (pain arising from the neck muscles).

Type of secondary headaches are:

•   Meningitis: inflammation of the meninges which presents with fever and meningismus, or stiff neck
• Bleeding inside the brain (intracranial hemorrhage)
• subarachnoid hemorrhage (acute, severe headache, stiff neck without fever)
• Ruptured aneurysm, arteriovenous malformation, intraparenchymal hemorrhage(headache only)
• Brain Tumor: dull headache, worse with exertion and change in position, accompanied by nausea and vomiting. often, the person will have nausea and vomiting for weeks before the headache starts.
• Temporal Arteritis: inflammatory disease of arteries common in the elderly (average age 70) with fever, headache, weight loss, jaw claudication, tender vessels by the temples, polymyalgia rheumatica
• Acute Closed Angle Glaucoma (increased pressure in the eyeball): headache that starts with eye pain, blurry vision, associated with nausea and vomiting. on physical exam, the person will have a red eye and a fixed, mid dilated pupil.

What Are the Signs and Symptoms

People experience many different types of headache, affecting a number of areas of the head in myriad ways, with differing intensities and for variable amounts of time. Here are the characteristic symptoms associated with some of the more prominent forms of headache:

Tension-type headaches

Tension- type headache is the most common type of headache and the one we think of as a normal, everyday headache. 

It may feel like a constant ache that affects both sides of the head. You may also feel the neck muscles tighten and a feeling of pressure behind the eyes.

Tension-type headaches can be either episodic or chronic. Episodic attacks are normally a few hours in duration, but can last for several days. In contrast, attacks are considered to be chronic if they occur for 15 or more days a month for a period of at least 3 months.

Signs and symptoms of a tension headache include: Dull, aching head pain. Sensation of tightness or pressure across your forehead or on the sides and back of your head. Tenderness on your scalp, neck and shoulder muscles.

Migraines

Migraine is the second most common form of primary headache and has been ranked as the seventh-highest specific cause of disability worldwide. The most common symptom of a migraine headache is a throbbing pain on one side of your head . You also may have other symptoms before, during, and after a migraine. Different people have different symptoms.  A migraine can last for any amount of time between a few hours and 2-3 days.

Symptoms associated with a migraine headache include:

• Nausea.
• Pain behind one eye or ear.
• Pain in the temples.
• Seeing spots or flashing lights.
• Sensitivity to light and/or sound.
• Temporary vision loss.
• Vomiting.

Rebound headaches

Rebound, or medication-overuse headaches are the most common secondary headache, caused by the excessive use of medication to treat headache symptoms. They usually begin early in the day and persist throughout, improving with pain medicine but worsening when its effects wear off.

Rebound headaches can cause a number of symptoms, and the pain can be different each day. Signs and symptoms of rebound headaches may differ according to the type of original headache being treated and the medication used. Rebound headaches tend to:

• Occur every day or nearly every day, often waking you in the early morning
• Improve with pain relief medication but then return as your medication wears off

Cluster headaches

Cluster headaches are a relatively uncommon form of primary headache that affect less than one in every 1,000 adults. They strike quickly, once or more daily at the same time each day and often without warning. They usually last between 45-90 minutes and persist for the duration of a cluster period, normally 4-8 weeks.

The pain caused by cluster headaches is severe, often described as sharp or burning, and is normally located in or around one eye. The affected area may become red and swollen, the eyelid may droop and the nasal passage on the affected side may become stuffy and runny. Infrequently, pain may extend into the ear, neck, or shoulder.

In general, children suffer from the same types of headaches as adults do, but their symptoms may be slightly different. The diagnostic approach to headache in children is similar to that of adults. However, young children may not be able to verbalize pain well. If a young child is fussy, they may have a headache.Just as in adults, most headaches are benign, but when head pain is accompanied with other symptoms such as speech problems, muscle weakness, and loss of vision, a more serious underlying cause may exist: hydrocephalus, meningitis, encephalitis, abscess, hemorrhage, tumor, blood clots, or head trauma. In these cases, the headache evaluation may include CT scan or MRI in order to look for possible structural disorders of the central nervous system.

How Can Headaches Be Prevented?

Muscle-tension headaches can often be avoided by maintaining proper posture and neck movements while performing your normal activities. Prevention methods include:

• Avoid slouching
• Avoid reading with your neck bent forward
• Keep your computer monitor at eye level
• Take frequent breaks from reading and working on the computer.
• Try a low-fat, high-complex carbohydrate diet. A recent study demonstrated that such a diet can dramatically lower the frequency, intensity, and\duration of migraine headaches.

What Is the Treatment for Headaches?

Headache treatment is cause-related. Doctors of chiropractic often treat patients with tension-type headaches and headaches caused by problems with the joints and muscles in the neck, as well.

Joint manipulation and mobilization of the neck, along with stretching and strengthening exercises, have been demonstrated to be effective in the treatment of this type of headache.

Massage and other forms of soft-tissue treatment can sometimes be helpful.

Scientists are also investigating other therapies, such as acupuncture, to prevent and treat this disorder. Over-the-counter pain relievers, such as acetaminophen, can be used for an occasional headache, but not for long-term headache management.

Conclusion

More serious causes of headache require aggressive treatment, and your doctor of chiropractic can assist you in finding a medical headache specialist.  The majority of patients with headache recover completely after treatment. Unfortunately, the recurrence rate is relatively high, particularly with tension-type headache. If you have any questions or concerns about headache, feel free to discuss them with your doctor or chiropractic.