Headache is a very common condition which results pain and discomfort in the head. In routine life almost everyone is familiar of it. Headache may occur on one side of the head or both sides. It is mainly divided into two broad categories. These are
- Primary headaches
- Secondary headaches
In primary headaches, there seems no pathology i.e they are idiopathic. Examples are migraine, cluster headache, tension-type headache.
It is recurrent type headache with severe throbbing pain. The pain is often on one side of head. It is usually familial i.e it runs in families. It is associated with other symptoms like nausea, sensitivity to light, vertigo, tinnitus. The attack usually remains from hours to two days, until subside by medical treatment like injections of diclofenac, triptans etc. sumatriptan is the drug of choice for migraine.
ACUTE ATTACK: triptans, NSAIDs like diclofenac.
CHRONIC: amitriptyline from TCAs, topiramate, sodium valproate, propranolol, verapamil.
2. CLUSTER HEADACHES:
It is a rare type of headache, affects males more often than females. It mainly occur between 15 to 40 years of age. Pain mostly present behind the eye, temple region, face region, upper jaw. Severe condition associated with rhinorrhea and lacrimation. Symptoms includes swelled eyelid of the affected side, drooping of the eyelid, redness of the eye. It has short duration of 20 minutes to few hours, but repeated everyday for weeks or months. There are two subtypes of cluster headache, these are episodic and chronic. Episodic is recurring on the same period of the day and presents with a remission or pause period, while chronic is frequent with no remission period.
TREATMENT: High tension oxygen, amitriptyline from TCAs, topiramate, sodium valproate, propranolol, verapamil.
3. TENSION TYPE HEADACHE:
Tension headache feels like a tight band around forehead. It is associated with stress and emotions. The best option for tension headache’s relief is to minimize the stress.
Headaches due to some special pathological causes. These are;
- Headache due to hypertension
- Headache due to DNS (deviated nasal septum) and sinusitis
- Headache due to vascular disorders i.e stroke, giant cell arteritis etc
- Headache due to brain tumors and increased intracranial pressure
- Headache due to vision problems