Headaches and its management 2 pages

headaches and its management?

There are several different types of headaches that affect people every day. Five have been shown to affect people the most and have their own list of symptoms, causes, and treatment. The first is tension headaches. They are the most common type. People feel pain from tension headaches at the back of the neck and head and especially at the temples. They do not interfere with daily activities and do not typically cause vomiting or nausea. People can manage tension headaches with OTC drugs like ibuprofen, Tylenol, or aspirin. They may be caused by stress, and/or potential fluctuations in brain chemicals.

Cluster headaches are more common for men versus women. They are recurring and occur in cycles or groups. They have sudden onset and are followed by debilitating, severe pain. People affected by cluster headaches tend to have nasal congestion/runny nose and a watery eye. When it happens, people cannot lie down or get comfortable. Cluster headaches may have a genetic component. Treatment lies in medications like Triptans, Octreotide, oxygen, local anesthetics, and dihydroergotamine. Most of these are injectable. Preventative therapy involves use of calcium channel blockers, lithium carbonate, or corticosteroids.

The next type is sinus headaches and these come from a sinus becoming inflamed due to infection. These headaches usually come with a fever. Treatment for these kinds of headaches involve antibiotics, decongestants, and/or antihistamines.

The fourth type is rebound headaches. These come from over use of OTC medications like Motrin, Advil, and Tylenol, although they may also include prescription drugs. Rebound headaches can also be a symptom of withdrawal from a medication and management involves decreased use of whatever medication was being abused.

The last type is migraine headaches. These can run in the family and are diagnosed when someone has had at least 5 prior episodes of headaches that last anywhere from 4 to 72 hours. People with migraines may develop one-sided pain, moderate or severe pain, throbbing pain, and pain that is debilitating. Sensitivity to light and sounds is also common. Similar to cluster headaches, treatment involves pain-relieving drugs and preventative medications. Preventative therapy is used for those experiencing severe and frequent migraines. Botox, cardiovascular drugs, and antidepressants are just some that may be used to prevent the onset of migraines.

2. What are the red flags of headache?

Headaches may be primary or secondary. Primary headaches include cluster headaches, migraines, and tension-type headaches. Secondary headaches tend to stem from sinusitis, glaucoma, idiopathic intracranial infection and hypertension, intracranial malignancy, and haemorrhage. Patient did not show any signs of these symptoms. She also presented a migraine with no aura. There was no halo and pain is located only on the right side. The thunderclap headache she did mention as a ‘lightning storm’. However, she’s not over 50 which is another red flag as that may signify development of temporal arteritis. The main thing she stated was she was on birth control and her family has a history of it. Birth control can be a major red flag.

Hormones can wreak havoc in a person’s body, especially a woman’s body. The birth control pill is meant to keep women from getting pregnant or fix hormonal imbalances a woman has. However, sometimes, there are severe side effects. Patient stated she would get intense migraines during her cycle. The role of the female sex hormone is migraines has been researched and can be a major migraine trigger for women. Some women have increased sensitivity to the fluctuation in progesterone and oestrogen when on contraceptive pills.

Migraines may be triggered from drops in oestrogen levels just before a woman’s period and in the later phase. Women that suffer from migraines after taking the pill are suggested to take low-dose pills. The other option is taking a 4-7-day break after taking the pill continuously for at minimum 3 cycles, helping maintain oestrogen levels constant. They also offer combination contraceptive pills, progesterone-only pills, and even non-hormonal methods of contraception.

References

Bernstein, C. & McArdle, E. (2008). The migraine brain. New York: Free Press.

Cohan, W. (2013). Headaches. New York, N.Y.: Demos Health.

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