Headache

Is this your symptom?

• Pain or discomfort of the head
• Not caused by an injury. That is covered in the Head Injury care guide.

Causes of Acute Headaches

There are many different causes of headaches. Most headaches are not harmful, but they can be caused by serious health problems. It is important to have severe or recurrent headaches checked by a doctor.

• Viral Illnesses. Many acute headaches are part of a viral illness. Flu is a common example. These headaches may relate to the level of fever. Most often, they last just a few days.
• Hunger Headaches. About 30% of people get a headache when they are hungry. It goes away within 30 minutes of eating something.
• MSG Headache. MSG (monosodium glutamate) is a flavor enhancer often added to soups or other foods. In larger amounts, it can cause the sudden onset of a throbbing headache. The face may also turn red or flushed.
• Other Common Harmless Causes. Hard exercise, bright sunlight, blowing a wind instrument or gum chewing have been reported. So has severe coughing. "Ice cream headaches" or "brain freeze" are triggered by any icy food or drink. The worst pain is between the eyes (bridge of nose) and passes quickly.
• Head Injury. Most just cause a scalp injury. This leads to a painful spot on the scalp for a few days. Severe, deeper or entire-head pain needs to be seen. Caution: a delayed headache, which starts days or weeks after a head injury and gets worse, can be due to a slow ongoing bleed on the surface of the brain. This needs an urgent exam (often with a brain scan). Go to ER Now.
• Sinus Infection (sinusitis) can cause a headache on the forehead. Other symptoms are stuffy nose and postnasal drip. Some sinus infections cause face pain. Headaches may occur if there is also a fever.

Serious Causes of Headaches

• Meningitis (very serious). A bacterial infection of the tissue that covers the spinal cord and brain. The main symptoms are a stiff neck, headache, confusion and fever.
• Subarachnoid Hemorrhage (very serious). This occurs when there is bleeding from a blood vessel on the surface of the brain. The headache is severe (worst ever) and comes on quickly. There may be neck pain and stiffness, so it may be hard to tell this from meningitis. Get an exam right away. Surgery is needed to stop the bleeding. A large bleed can be deadly if not treated quickly.
• Subdural hematoma. This is a blood clot on the surface of the brain. It is often from a head injury and may or may not be noticed at the time. A slowly increasing headache which starts after a head injury (or even a few weeks later) can be from a slowly growing blood clot. Get this checked out.
• Giant Cell Arteritis (serious). It is from inflamed arteries in the temple as a result of an odd immune response. It often feels like a headache at the side of the head (temple), scalp pain, visual change or loss, and pain in the jaw when eating. There may also be muscle pain, fever and feeling ill. It occurs more often in people older than 50 years. Get it checked right away. Treatment is needed to prevent vision loss.
• Acute Closed Angle Glaucoma (serious). The symptoms are a headache, severe eye pain and a red eye. It is from a buildup of pressure in the eye.
• Carbon Monoxide Poisoning. Carbon Monoxide is a poisonous gas that has no smell. It can cause brain damage or even death. Exposure to exhaust fumes in a confined space will expose you to carbon monoxide. Sources may be car exhaust, barbeques, heaters, or blocked chimney flues. Without a carbon monoxide detector, you would not be aware you are in danger. Symptoms include headache, nausea, dizziness, abdominal pain, flushing, feeling weak and trouble concentrating. More exposure can cause loss of consciousness and death. If exposed, get into the fresh air right away. Contact your doctor for advice.

Causes of Recurrent Headaches

• Migraine Headaches are severe, very painful headaches that keep you from doing normal activities. They are often throbbing and can happen just on one side. Symptoms have a sudden onset and offset. Vomiting or nausea happen in 80%. Lights and sound make them worse. Most people want to lie down in a dark, quiet room when they have a migraine. Migraines often run in the family (genetic). They can be triggered by foods such as chocolate, cheese or alcohol. They may occur with the menstrual cycle in women. Stress and lack of sleep can also trigger migraines.
• Tension Headaches are the most common type of frequent headaches in younger people. Headaches that start after age 50 should be checked to rule out other causes. Muscle tension headaches give a feeling of tightness around the head. The neck muscles also become sore and tight. The headaches can be caused by staying in one position for a long time. This can happen when reading or using a computer. Other people get tension headaches as a reaction to stress or worry. These headaches can occur once in a while or often (more than 15 times a month). Treating the cause will help reduce the headaches. Tension headaches usually come on more slowly, don't throb, and are less severe than migraine headaches.
• Cluster Headaches. With this type of headache, there are attacks of severe one-sided pain in the face around the eye, temple and forehead. The neck and rest of the head can be affected. The pain comes on over about 10 minutes. There is also eye redness and a stuffy nose on the same side of the face. These headaches are more common in men, people who smoke and adults older than 20 years of age. Attacks often occur at night and can last for 15 minutes to around 3 hours . The cause is not fully understood, but they may be genetic. Triggers are alcohol, certain medicines, heat, exercise and others.
• Headaches Caused by Overuse of Medicines or other trigger substances. Headaches can be caused by:
  • Taking medicines (prescribed or over-the-counter), often if used in high doses. Overuse of pain meds in high doses is a common cause. Most often happens with OTC meds. Treatment is reducing the use of pain meds, if you can, and taking pain meds at the correct dosage.
  • Withdrawal from these substances can also trigger headaches.
  • Long term use of birth control pills or hormone replacement therapy.
  • Other trigger substances, such as drinks containing caffeine or exposure to carbon monoxide.
• Not Due to Needing Glasses (vision headaches). Poor vision and straining to see the distant items can cause eye pain. Sometimes, it also causes a muscle tension headache. But, getting glasses rarely solves a headache problem that doesn't also have eye pain.

Pain Scale

• Mild: you feel some pain, but it does not keep you from normal activities. Work, activities and sleep are not changed.
• Moderate: the pain keeps you from doing some normal activities. It may wake you up from sleep.
• Severe: the pain is very bad. It keeps you from doing all normal activities.