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June 2008: Determining the Root of Your Headache

01 Jun 2008

Dr. Michele Del Signore is a board-certified neurologist at Lakefront Medical Associates located at Weiss Memorial Hospital. Her interests lie in stroke and women’s health.

Determining the Root of Your Headache

Dr. Michele Del Signore
Neurologist
Lakefront Medical Associates
Weiss Memorial Hospital
(773) 564-5778

We have all, at some time in our lives, been affected by a headache. Headache and backache are two of the most common reasons for seeking medical attention. Headaches can vary in severity, quality of pain, duration and frequency. Headaches vary in location as well. Not every headache indicates an underlying significant disease process, but headaches that disrupt your ability to work and enjoy life need to be evaluated by a medical professional.

Most headaches are self-limiting and are relieved by over the counter medications such as acetaminophen or ibuprofen. These headaches are not usually serious or life threatening. However, people who suffer frequent headaches or severe headaches require medical attention. These headaches can be categorized and treated appropriately when the right questions are asked. If not properly diagnosed and treated, headaches quickly reduce productivity and quality of life for those who suffer from them.

Types of headaches
The brain itself is not sensitive to pain. It is documented that head pain is mediated through neurotransmitters in the brain, muscles of the skull, and neck and blood vessels.

Migraine headaches require diagnosis by a medical professional and are categorized as vascular headaches. These headaches are common among younger generations and tend to cause a decrease in productivity because they are a main cause of days missed at work. Migraines are severe and may be associated with certain triggers. They may involve visual disturbances and nausea. Women are more commonly affected than men. Migraines can even be associated with menstrual cycles. Often, patients will express a sensation or a feeling that the headache is going to occur. Abortive migraine medications are very useful in these patients. Migraine headaches are often misdiagnosed as sinus headaches due to the similar presentation. Many medications have been approved for the treatment of migraine headaches as well as prevention for those who suffer from many headaches during the course of a month.

Muscular, or tension headaches, tend to present as a band like sensation around the head and have a squeezing or tightening quality to them. Head pain can also originate from the neck and be associated with neck pain and upper extremity symptoms.

Certain headaches need immediate medical attention, such as:

  • Any headache of severe, acute onset with neck stiffness and changes in level of consciousness. Such symptoms may indicate a possible aneurysm rupture.
  • Severe headaches associated with fever and neck stiffness. These symptoms may represent a brain bleed or infection.
  • Headaches following a blow to the head. Such injuries need to be assessed for brain bleeding.
  • Headaches associated with tenderness or pain in the temporal region that is persistent or involves vision loss, particularly in the elderly. Such symptoms are serious and require immediate work up.

Diagnosing the cause of your headaches
Diagnosing headaches requires a medical professional to take a thorough medical history and perform a detailed physical exam. Imaging of the brain with CT and MRI scans are often vital in making the appropriate headache diagnosis. Certain blood tests are of value as well. All of these steps will help to get you on the right track to feeling better and keeping your particular headache problem under control.

For more information
If you would like more information about headaches and their causes, talk to your doctor or call Lakefront Medical Associates, at (773) 564-5778.