Headaches are probably of the most common type of pain experienced by humans at one point of their life irrespective of their age, race, occupation, and gender which can be due to stress, tension, blood clots, high blood pressure or brain disease which can affect one's activities of daily living.
According to the World Health Organization (WHO) reports it showed that almost half of all adults worldwide will experience a headache in any given year.

According to the International Headache Society (IHS) diagnostic criteria, headaches are classified based on the characteristics of the headache. Which include:

  • Tension-type
  • Migraine
  • Cluster headaches.

Tension--type headches
This Is the most common type of Headache. It is characterized by its bilateral location and pressing or tightening qualities. It is usually of mild or moderate intensity. It can be an infrequent, frequent episode or chronic. The victim has a feeling of a:

  • Tight band around the head.
  • Constant dull ache on both sides of the head.
  •  Pain spreading to or from the neck

Migraine Headaches
This is a recurring Headache characterized by unilateral or bilateral throbbing, pulsating pain, strong family history, triggering event and manifestations associated with dysfunction of the neurologic and autonomic nervous systems.It is most common in girls during puberty, and in their late teen's females are about twice as likely to suffer migraine as males.
It may be triggered by foods(cheese, oranges, red wine, alcohol), head trauma, fatigue, stress, hormonal fluctuations etc.A migraine headache may cause a pulsating, throbbing pain usually only on one side of the head.
The aching may be accompanied by:
  • Aura: which may last for 10 to 30minutes before the Headache start presenting with sensory dysfunction (visual field defects, tingling sensations, paresthesias), motor dysfunction (weakness, paralysis) dizziness, confusion and even loss of consciousness.
  • Irritability.
  • Pallor.
  • Sweating.
  • Nausea.
  • Vomiting.
  • People with migraine may tend to run away from noise, light, odors, people and problems.

Cluster headaches
These are a rare form of headache. It involves repeated headaches that can occur for weeks to months at a time which is followed by periods of remission. Though the cause of cluster headaches is not fully known but dysfunction of intracranial blood vessels and pain modulation systems, alcohol ingestion can trigger it.
It presents with the following:
  • Sharp and stabbing pain lasting for about an hour typically for 4 to 8 weeks.Located in or around one eye radiating to the temple, forehead, cheek, nose, and guns.
  • Swelling around the eye
  • Facial flushing, rhinitis or pupils constriction
  • 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.

Tension, migraine and cluster headaches are the most common types of headaches but other headaches can still occur. These kinds of headaches can accompany subarachnoid hemorrhage, brain tumors, arteritis, vascular abnormalities, trigeminal neuralgia, systemic illness(bacteremia, carbon monoxide poison, Polycythemia Vera), ruptured or unruptured aneurysms and diseases of the eyes, nose, and teeth. They are also called "secondary headaches". The symptoms carry greatly, an in-depth clinical evaluation must be carried out looking into the individual's personality, life adjustment, environment, neurologic status, and family situation.

Rebound headaches
Rebound or medication-overuse headaches stem from excessive use of medication to treat headache symptoms. They are the most common cause of secondary headaches. They usually begin early in the day and persist throughout the day. They may improve with pain medication, but worsen when its effects wear off.

Along with the headache itself, rebound headaches can cause:

  • Neck pain
  • Restlessness
  • A feeling of nasal congestion
  • Reduced sleep quality

Rebound headaches can cause a range of symptoms, and the pain can be different each day.

  • History and physical examination:
  • Neurologic examination (which is often negative)
  • Local infections inspection
  • Palpations for tenderness and bone swellings
  • Auscultation for bruits over major arteries
  • Routine laboratory studies:
  • Complete blood count
  • Electrolytes
  • Urinalysis
  • Special studies:
  • Computed Tomography scan of the sinuses
  • Angiography
  • Electroencephalography
  • Electromyography
  • Magnetic resonance angiography
  • Magnetic resonance imaging

  • Biofeedback
  • Cognitive-behavioral therapy
  • Meditation
  • Yoga
  • Relaxation training
  • Acupuncture
  • Acupressure
  • Hypnosis
  • Drug therapies depending on the type of headaches such as Non-opioid analgesic e.g aspirin, acetaminophen)which can be used alone or combine with a sedative,muscle relaxants or tranquilizers, serotonin receptors e.g Sumatriptan(Imitrex)  Beta-adrenergic blockers e.g propranolol (Inderal),Tricyclic antidepressants e.g Doxepin(Sinequan) and prophylactic drugs such as verapamil, ergotamine.

  • Manage stress wisely.
  • Engage in exercises e.g yoga, deep breathing exercises.
  • Drink a lot of water daily.
  • Eat an adequate diet
  • Consume fruits and vegetables
  • Do not skip breakfast
  • Get enough sleep, avoid sleep debt.
  • Maintain good posture.
  • Avoid caffeinated drinks
  • Avoid smoking and drinking excessively.
  • Avoid unnecessary shouting and noise.
  • Work and sleep in a safe, well ventilated environment.
  • Have a to-do list to avoid overworking.

American Association for Headache Education (ACHE) 856-423-0258 www.achenet.org

Lipton RB ,Bigal ME: Migraine: epidemiology, impact,and risk factors for progression, Headache 45(suppl) 1:S3
National Headache Foundation 888-NHF -5552 www.headaches.org

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