CHENNAI: For some patients, the headache is so severe that they hit their head on the wall to relieve the pain,” says Dr Sivarajan Thandeswaran, senior consultant, Stroke & Neurovascular Medicine, Kauvery Hospital, Chennai, talking about one of the most common kind of headaches called cluster headaches. “They can be misdiagnosed as some other form of headache.
Hence, along with the patients noticing the symptoms, doctors must also take time with the patient to understand the kind of headache they have,” he insists. Dr Sivarajan points out that there are several types and one has to notice the triggers and symptoms to know which category they fall into. Medically, headaches are categorised as primary or secondary.
Primary headaches occur frequently and can be reduced almost immediately by popping pills, whereas secondary headaches can be because of a brain growth or inflammation, fever, dehydration or other external factors. “Almost 95 per cent of the time, we encounter primary headaches like migraine, tension-type headache, or cluster headache.
The other common ones are cold-stimulus headache, which sets in after one eats an ice-cream, some get exercise-induced headache, headache due to trigeminal neuralgia, or primary-stabbing headache. Another often misunderstood kind of headache is primary paroxysmal hemicrania where the patient gets two-three stab-like feeling in their head and it disappears. It appears again a few minutes later. This can happen almost 100 times in a day. There is a lot of grey area between different types of headaches. Some can have even more than one kind of headache. It is up to the doctors to ask specific questions and treat the patients accordingly,” he explains.
QUICK CHECK
Secondary headaches have red-flag signs. If someone has sudden and severe headache, nausea, vomiting, loss of awareness or consciousness, then they should immediately think of stroke or bleeding in the brain or tumour. Do not wait for doctor in the clinic or for the pain to subside. Immediately go to the emergency
room or it can lead to a life-threatening situation.
STIMULUS HEADACHE
Site of pain
It is similar to tension headaches. The pain is felt all around the head.
Symptoms & relief
These are trigger headaches caused when you eat an ice-cream or exercise. Just avoid the triggers.
MIGRAINE
One of the most common kinds of headache is migraine. It is hereditary and is seen more in women than men.
Site of pain
The pain is usually one-sided — around the sides of forehead, or above the ear. It spreads slowly to involve the back of the head.
Symptoms & relief
Patients have often associated additional issues like vomiting sensation, vertigo, and fogginess. Some patients complain of aura; they see scintillations or zigzag lines. Some even get a stomach-ache first before getting the headache. Some others might not have the pain but may feel heaviness. That should not be ignored. When the pain is associated with severe vertigo or nausea it is called migraine with brain stem aura. Another easy way to identify a migraine is the patient often wakes up with a headache. Migraine treatments are aplenty. It is targeted in two ways — one is to give aborters to reduce acute attack, and the other is preventers for those who have more than four attacks a month.
Unfortunately, preventers can induce weight gain, and especially middle-aged women and teenagers will have to watch out and inform their doctor. Though you might have the migraine gene and be vulnerable, it is usually triggered by one’s lifestyle especially sleeping late, spending too much screen-time, not eating on time, and dehydration. It is easy to avoid migraine if you are disciplined. Some patients might also have specific triggers like ice-creams, sour foods, scents; if you make note of it you can avoid the pain. Sun exposure can cause instant headache to those with migraine. Always wear a sunglass and a hat when you step out.
SINUS HEADACHE
Site of pain
Often centered above the nose, on both sides of the nose.
Symptoms & relief
They usually occur during flu season. But some people are sensitive to dust, pollution or pollen and these can cause nasal stuffiness and sinus headaches. Because of the stuffiness of the nasal passage, the sinus cannot drain mucus properly and hence, gets clogged up. The pressure inside the sinus causes the headache. Some feel better when they take nasal decongestion drops. If it is clogged up completely, the patient has to go through endoscope to release mucus. Healthy allergy medicine plus/minus antibiotics can get you out of sinus headaches, but doctors also check the immune functions of the patient, specially if they are hypersensitive.
CLUSTER HEADACHE
Site of pain
Patients with cluster headache feel a very intense, tearing type of pain behind the eye.
Symptoms & relief
They have severe watering from the eyes and nose. Cluster headache is named so as they come in clusters — it comes for a few days and disappears, and again comes back. A patient might get 3-4 attacks a year. It is the most severe form of headache. The treatment for this is very novel. Doctors administer high flow oxygen to the patient and within ten minutes the pain disappears. Patients who are
aware of their condition should know of nearby clinics/hospital to get the high flow oxygen treatment so that they don’t have to suffer for days.
TENSION TYPE HEADACHE (TTH)
It is the most common kind of headache
Site of pain
You experience a band-like pain across the forehead and it may move towards the sides, above the ear, and down the neck too. TTH does not last the whole day; it typically lasts for 1-2 hours, goes away and comes back. Often it sets in at the end of the day especially if you have spent long hours in front of a screen or have been riding a two-wheeler.
Symptoms & relief
The muscles in between the eyebrows and smaller muscles in the head get tense and get a spasm. That triggers the pain. Medicines are given to relax the muscles and the pain to subside. As it often sets in when one is stressed, or even very angry, it is easy to take away the triggers.