Headaches, overview

Notes
  • They involve mild to severe pain in one or more parts of the head as well as the back of the neck.
  • They contribute to some of the most common reasons that prompt patients to seek medical attention.
  • They are associated with disability and major financial costs to society.
  • They are classified into two broad categories: Primary headache disorders and secondary headache
  • A majority of people with headache disorders worldwide are NOT professionally diagnosed
  • Globally, headache has been underestimated, under-recognized and undertreated
  • Primary headache disorders include: Tension-type headache, Migraine, and Cluster headache (with the first two being the most common causes of all headaches)
  • Secondary headache has multiple etiology that include various infections, acute hypertension, sinusitis, glaucoma, dental problems, brain tumors, hemorrhage in the brain, drugs such as nitrates, carbon monoxide, caffeine withdrawal, medication-overuse headache (or rebound headache, that is one of the most common causes of secondary headaches), fever and hypercapnia among others
  • Headaches can themselves cause illness such as depression (that is 3 more common in individuals with severe headaches than in healthy people)
  • Statistics: about 47% of adults worldwide will have experienced a headache within a year; the prevalence of migraine and tension-type headache globally is 40% while that of medication-overuse headache (MOH) is 10%.
Symptoms
  • Clinical evaluation
Diagnosis
  • Clinical evaluation
  • Tests to exclude any suspected secondary causes e.g. tests for malaria, brucellosis and typhoid among others
  • CT Scan of the head
  • MRI of the head
  • Lumbar puncture and CSF analysis
  • Sinus X-rays
  • Temporal artery biopsy.
  • Tonometry, if acute narrow-angle glaucoma is suspected
Differential
  • Not applicable
Prevention
  • It depends on the established or suspected cause(s)
Management
  • It depends on the established or suspected cause(s)
  • Analgesics such as paracetamol, aspirin and ibuprofen among others
  • Taking a rest
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