Headache

Headache is perhaps the commonest symptom that affects mankind. indeed it would be unusual to come across an adult who has not suffered from it at least once during his or her lifetime. Headache is usually caused by many factors such as the irritation of the nerves present in the skullcap and the other structures of the head, or due to emotional tension. The structures involved include the eyes, nasal passage and sinuses, teeth, bones of the neck, muscles, and blood vessels. The headache may be present in the exact area where these structures are situated, or it may be referred to another area of the head. Headaches arising from structures outside the skull are often due to refractive errors of the eye. This also causes poor eyesight. These headaches are usually felt in the front of the eyes and get worse with the use of the eyes. The treatment is to wear corrective spectacles. Headaches arising from congestion or infection of the sinuses, (called sinusitis) which are cavities in the bones of the skull that are in communication with the nose passage, are usually localized to the site of the sinus. For example, in a patient with congestion of the frontal sinus, which is situated inside the forehead above the eyes, the headache will be present in the front of the head (forehead). This is the commonest sinus that gets infected. However, there are other sinuses that are behind and on either side of the nose, and these too can get infected. Headache of sinusitis is accompanied by other symptoms such as nasal stuffiness, nasal discharge, pain over the sinuses when pressure is applied, and bad breath. 

Septic (infected) or loose teeth could irritate the nerve endings present at the roots of the teeth causing pain that radiates to the head. Removal of these diseased teeth would alleviate these Headache arising from the bones of the neck (cervical spine), is not an uncommon cause of headache particularly in elderly people. The bones of the neck get worn off as age increases, and these diseased bones could press on nerves that come out between them. These headaches are usually felt in the back of the head and are accompanied by pain and limitation of neck movements. Headaches arising from irritation of nerves, muscles and blood vessels in the skull: There are certain nerves that supply the structures of the head that can give rise to pain in the head (neuralgic headaches), These headaches are very severe and are precipitated by stimulation of structures supplied by the nerve. Certain blood vessels of the head have a rich supply of nerves on their walls. Stimulation of these nerve endings due to dilatation of these blood vessels causes a common type of headache known as migraine. The headache of migraine classically comes on in bouts and is usually confined to one half of the head at the onset. It usually occurs in  young adolescents,young adults and in middle age.It usually passes off after  middle age. Often there is a family history of migraine. It is commonly aooompmied by other symptoms such as nausea, vomiting and visual disturbances, 

Drugs such as propanolol and funarazine are used in preventing attacks; imigran (Sumatriptan) is a drug that is effective in bringing quick relief. Headaches are commonly an associated feature of any fever. Fever dilates the blood vessels in the head, giving rise to headache. Headache is sometimes a symptom of high blood pressure. Emotional tension, in both adults and children, is a common cause of headache. Layers of muscles cover the skullcap; headache occurs when these muscles become tense. These headaches are therefore called tension headaches; they are closely related to emotional disturbances and anxiety. The headache may be felt as a band or cap- like pressure over the head. Headaches arising from the brain and its coverings (meninges): tumors, infections (e.g. meningitis, encephalitis) or other lesions of the brain (e.g. brain hemorrhage) and its coverings may cause headaches. These headaches could initially come on in bouts but later become progressive. They could have a bursting quality, wake up the patient from sleep in the morning and be associated with vomiting.

Treatment of headaches

A pain-relieving drug, such as aspirin or paracetamol, usually relieves headaches. But they are bound to recur unless the cause of the headache is detected and treated. Medical advice should be sought for headaches, which have any of the features like headache which lasts for more than a week, severe headache of any duration, headache associated with blurring of vision, vomiting, weakness or numbness of limbs.