What Is Headache?
Headache is a very common complaint and does not refer to a single disease. In addition to primary headaches such as migraine, tension-type headache and cluster headache, secondary headaches due to infection, vascular diseases, medication use or other medical conditions can also be seen.
What Is Important in Headache Assessment?
When the headache began, how long it lasted, the location and character of the pain, accompanying nausea, light-sound sensitivity, visual symptoms and situations that increase or decrease the pain are important for the diagnosis. The frequency of the painkillers used must also be assessed.
Which Headaches Require Emergency Assessment?
If one of the following features is present, medical assessment is needed without delay:
- Headache that begins suddenly and becomes very severe within seconds to minutes
- Headache accompanied by weakness, speech disorder, change in consciousness or new neurological findings
- Headache together with fever and neck stiffness
- Headache that occurs after a new head trauma or is progressively increasing
- New and severe headache during pregnancy or the postpartum period
- New headache in a person with a history of cancer or immune system suppression
- Headache that occurs for the first time, particularly at an advanced age, or whose character changes markedly
Migraine and Tension-Type Headache
Migraine can often be of a throbbing character; nausea, light and sound sensitivity may accompany it. In some people, visual or sensory aura symptoms may be seen before or during the pain. Tension-type headache, on the other hand, is more often described as tightening or pressure-like and is mostly of mild-to-moderate severity.
How Is Headache Diagnosed?
In many primary headaches, the diagnosis can be made through a detailed history and neurological examination. Imaging is not needed in every headache. However, if deemed necessary because of the examination findings, the characteristics of the headache or accompanying risk factors, a brain MRI, CT or other investigations may be requested.
Headache Treatment
Treatment is planned according to the type and frequency of the headache and the person’s other health conditions. In addition to attack treatments, preventive treatments can be considered in headaches that are frequent or lead to loss of function. Sleep routine, adequate fluid intake, regular nutrition, exercise and noticing personal triggers can also be part of the management.
Since very frequent use of painkillers can lead to medication-overuse headache in some people, the frequency of use should be assessed together with the physician.
Practice and contact information
This content has been prepared for general informational purposes; it does not replace personal diagnosis or treatment advice.
