Headache is a common symptom that more than 90% of the population experiences it. Headaches can occur in one or both sides of the head, in specific areas, or in radiated forms.
The causes of headaches are very diverse, and brain diseases such as brain tumors, cerebrovascular diseases, encephalitis and meningitis are also some of the causes. However, unlike worries, the causative disease in the cranium is known to be within 1% of all headaches. The most common headache is tension-type headache, but migraine is the most common type of headache when visiting a hospital.
Headaches can have a variety of patterns, as well as various causes, and may be accompanied by additional symptoms other than head pain. It may appear as a sharp sting, a tingling sensation, or heavy pain. The pain may start slowly or may start suddenly, or within an hour or as long as several days. You should suspect dangerous organic brain disease when:
When a new type of severe headache that you have never experienced begins suddenly
When headaches get worse over several days or weeks
When headache appears after overwork, tension, coughing, stool, or sexual intercourse
When the headache started for the first time after 50 years
When there is an abnormal behavior, drowsiness, loss of consciousness, decreased memory, fever, vomiting, motor or sensory symptoms, visual impairment, diplopia, gait disorder, or loss of balance
Most headaches are diagnosed with the appearance and frequency of the headache, but if a causative disease is suspected, a detailed examination such as computed tomography (CT) or magnetic resonance imaging (MRI) is necessary. Computed tomography (CT) is very accurate in the diagnosis of brain hemorrhage, but it is difficult to diagnose lesions in the posterior part of the brain due to adjacent structures such as the skull. Therefore, magnetic resonance imaging (MRI) is usually performed as a differential test for the causes of headaches, excluding brain hemorrhage. In addition, cerebrospinal fluid or cerebrovascular tests are performed to diagnose meningitis and subarachnoid hemorrhage. Cervical radiography or cerebral blood flow tests may be done in some cases.
Treatment is different depending on whether it is a primary or secondary headache, and the treatment method and prognosis are different depending on the cause of secondary headache. Primary headaches usually heal on their own, but if it is difficult to tolerate, use painkillers such as Tylenol. Even in the case of primary headache, it is recommended to visit the hospital if the number of headaches increases or the number of medications increases. In the case of secondary headaches, treating the cause has priority. In cases where meningitis, brain hemorrhage, brain tumor, and lead poisoning are suspected, the patient should go to the hospital immediately for prompt treatment.
Progress and complications
- Cluster headache
- It usually has the highest prevalence in the 40s, and then gradually decreases and rarely persists until after the age of 70. Patients suffer from cluster headaches because they cause a very strong degree of headache. However, it rarely leaves long-term sequelae.
- Tension headache
- It usually responds well to treatment unless it progresses chronically, leaving no long-term complications or sequelae. In the long run, about 50% of patients have improved headaches, but the other half are known to develop chronic tension or overdose headaches.
- Overdose headache
- It can be controlled to some extent by stopping the drug or by administering drugs that have not been used previously. However, patients often take medications that they had previously taken, and treatments often fail.
- Write a headache diary to confirm the correct trigger factor.
- Avoid foods that cause headaches.
- Regular eating habits are important because fasting can be a trigger.
- Make sleep habits as regular as possible.
- If stress is a trigger, try to relieve tension.