Everyone experiences headaches at some time or other and all home medicine chests contain mild painkillers.
Simple factors such as excessive noise—in a discotheque for instance — or a chronic cough, lack of sleep or tension can cause a headache in an otherwise healthy person.
But a headache is also an extremely common symptom of more serious conditions such as nose, throat and ear infections, high blood pressure, and damaged blood vessels or brain tumour.
If you have a headache that persists, recurs or is particularly severe, or a headache accompanied by other symptoms you should go to your doctor as it may need treatment.
Diagnosis The exact site and nature of the pain helps to trace the cause and it is important to tell the doctor as much as possible about when and how the headache started.
The doctor will usually examine the eyes and take the patient’s blood pressure. If the diagnosis is still in doubt the patient may see a neurologist and have skull X-rays taken, or possibly a CT scan, a series of X-rays which produce a computerized picture of the brain.
Common causes The brain itself cannot feel pain but the tiny nerve endings within the arteries and veins that supply the brain are very sensitive to changes of pressure.
All sorts of conditions, such as tension and fatigue, can affect the pressure and result in a headache, but why exactly it happens is not known…
The sensation of pain is also transmitted to the brain by substances called prostaglandins from nerve endings in skin, the eyes, ears and nose.
The most common headaches are ones that develop with a mild virus infection like a cold, or with tension from intense concentration or worry.
These are usually mild and clear up quickly with the help of simple painkillers such as aspirin.
Migraine is an intense type of headache, thought to be caused by the blood vessels on the one side of the brain first contracting and then dilating.
Neuralgia A pain actually arising in a nerve. When it happens in nerves supplying the head or face headache is acute and may be set off by the touch of a brush or comb.
More serious causes Brain tumours, although not common, can cause persistent headache, usually accompanied by other symptoms snch as vomiting. Careful investigation is needed to plot the exact site and plan appropriate treatment.
Meningitis is an inflammation of the meninges, the tissue layers covering the brain and spinal cord and separating them from their bony casing. The patient develops a severe headache, a stiff neck and a dislike of light (photophobia). Treatment is usually by means of drugs for bacterial infections and rest.
If blood vessels supplying the brain are damaged in an accident it can lead to blood leaking in the space between the skull and the brain tissue, or may even cause a blood clot. A severe headache may be the first sign that something is wrong. The condition may be self-correcting or surgery may be required.
Because the symptom of headache has so many causes the information given by a patient is very important and may give the diagnosis before examination and tests confirm it. Remember when the headache started and if there were warnings. Note the frequency of the attacks and how long they last.