Headache

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Headache is a definition used for pain originating from the upper part of the head and neck. Pain is a type of pain caused by the thin periosteum around the skull bone, muscles, eyes, ears, cerebral membranes and vessels around the brain due to the lack of pain sensation in the brain and skull.

It is one of the most common complaints in the society. On the other hand, 90 percent of all headaches are migraine and tension headaches.
Headaches can be divided into primary and secondary.

Primary headaches: These are migraine, tension type and cluster headaches.

Secondary headaches: It is seen in 10 percent. Its cause depends on a particular disease. They are headaches that occur during the course of diseases such as cerebrovascular diseases, nervous system diseases, brain tumors, eye diseases, sinusitis, and meningitis.

 

Primary Headaches

 

• Tension headache: It is the most common type of headache. It is more common in women. Tension type headache is seen in 1 out of 20 people in the world.

• Migraine: It is the second most common primary headache type. It can be observed in children as well as in adults. While it is equally prevalent in girls and boys before puberty, it is more common in girls after puberty.

• Cluster headaches: This is a less common type of headache. It is a type of headache that is more common in men than women. Although these types of pain are not life-threatening, they disrupt the comfort of daily life.

 

Secondary Headaches

 

It is a type of headache that develops due to structural or infection in the head and neck. Some of these reasons include sinusitis , brain hemorrhage , meningitis, tumor, increased intracranial pressure, head trauma, high blood pressure , sleep apnea. Secondary headache usually occurs suddenly, does not respond to rest and medications, and its severity increases over time. Pain is usually felt on the same side of the head. Along with the headache, there may be complaints of numbness, loss of strength and visual impairment in a part of the body. The severity of the pain increases over time.

 

Migraine

 

Of all headaches, it is the disease that is the most common reason for consulting a doctor. It is known that approximately 20% of women and 8% of men in the society have migraine. Apart from its negative effects during attacks, it also has chronic effects such as a decrease in school and work performance and social problems. There is no special laboratory test or radiological examination for the diagnosis of migraine.

 

Characteristic signs of migraine

 

• Usually the pain is on one side of the head

• Pain is throbbing, moderate or severe

• Is repetitive

• Nausea, vomiting occurs

• In case of attacks, crises come

• Pain lasts 4 to 72 hours

• Visual disturbances occur at the onset of pain (with aura type)

• Pain increases with head movements and physical activity

• Being disturbed by light and sound

• Hypersensitivity-reactivity, depressive mood

• Euphoria, rarely hyperactive

• Stagnation / dullness, decreased concentration and attention, slow thinking

• Difficulty finding words, stuck while speaking

• Increased light-sound-odor sensitivity

• Wanting to yawn, to sleep

• Neck stiffness

• Weakness

• Hunger, cravings for sweets, increased appetite or loss of appetite

• Excessive drinking, water retention, frequent urination

• Abdominal swelling, constipation or diarrhea

 

Types of Migraine

It is divided into two groups. Migraine with and without aura. Only 10 percent of migraines have aura. Aura are symptoms encountered in pro-symptom migraine. Most of these symptoms are vision related. The patient reports seeing bright lights, zigzag lines, or blurred vision, loss of vision in an area or region. In addition, numbness in the arms and legs, dizziness, speech disorders can also be seen. It takes 20-30 minutes and then the pain begins.

 

Causes That Trigger Migraine

 

• Height changes

• Air pollution, cigarette smoke

• Bright light or flickering light

• Loud and continuous noise

• Perfume odor, other strong odors and chemicals

• Changes in weather conditions (pressure, temperature and humidity change, lodos)

• Seasonal changes (autumn and spring worst times)

• Hunger, skipping meals

• Too much or too little sleep, disturbances in sleep patterns

• Air travel

• Birth control pills

• Hormonal changes in women (menstrual period)

• Some foods and drinks (chocolate, nuts, red wine, etc.)

Migraine Treatment

 

Basic treatment is divided into two as preventive and relapse treatment. If the patient's pain is seen once or twice a month, treatment is recommended only during an attack.

Simple pain relievers, nonsteroidal anti-inflammatory drugs, ergotamine drugs and triptans are used in pain treatment. Anti-emetic drugs are given for nausea and vomiting during attacks. Painkillers should be taken at the beginning of the attack.

If the number of attacks exceeds three and four in a month, it is necessary to use drugs to prevent the attack. In preventive treatment, drugs are taken every day.

Tension Type Headache Treatment

 

Pain relievers, muscle relaxants and antidepressants are used in the medication treatment of tension headache.

 

Cluster headache

 

It is seen in young men. It usually starts around the age of 20. It comes in attacks during a certain period of the year. These periods, which prefer seasonal transitions, last about 15-45 days. During this period, there are attacks that usually last about 30 minutes every day. In general, there is 1 attack that repeats at the same time every day, and up to 8 attacks. When the attacks are over, there will be silence for long months. Nausea and vomiting are rare. There is sweating. It can be distinguished from migraine by being seasonal, choosing certain times of the day, and having a rhythm in itself.

 

Cluster Headache Symptoms

• Excruciating pain usually concentrates around the eyes, but can also spread to other areas such as the head, face, neck and shoulders.

• Unilateral severe pain,
• restlessness,
• Excessive sweating,
Redness of the eye on the affected side,
• Congestion and runny nose in the affected side of your face,
• Sweaty, pale facial skin,

Swelling around the eye on the affected side of your face,
• Decrease in pupil size,
• Drooping of the eyelid.

 

Acute treatment

 

Oxygen

Triptans

Octreotide

Local anesthetics

Dihydroergotamine

 

 

Preventive treatments

 

Calcium channel blockers

Corticosteroids

Lithium carbonate

Nerve block

• Ergotes

Melatonin

Dr. Tamer Tekin