“Its Loud Inside My Head”

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The neurological condition in which any part of the head (from forehead to nape of the neck) feels a pain that can be sharp or dull is termed as headache. The pain may even shift to the periorbital area like pain in the jaw line or similar. As headaches are a common occurrence, most of us end up self-medicating with over-the-counter drugs, implement simple lifestyle modification, exercises, to feel better. Depending on the duration and intensity of pain headaches may lead to more complex symptoms and this is where it needs intervention. Studies shows that headache disorders, and migraine in particular, are important causes of disability worldwide, and deserve greater attention.
Migraine is a disorder of recurrent attack that comes and goes. The location of migraine is mostly unilateral 70% of the time. The characteristic of this headache is the gradual onset, moderate to severe intensity for the pain. The estimated global prevalence of migraine is about 14.7% as per WHO. Read more about the symptoms, duration and the stages below.


The etiology of headache is – when there is any irritation or traction to meninges and blood vessels, headache happens. An incorrect diagnosis about the heachache type may lead to wrong medication or therapy thereby resulting more pain than relief. Hence it becomes important to identify the type of headache one is experiencing according to the symptoms and place of the originating pain. Though this disorder is pretty common, not all of us are aware about the type of headache we are dealing with. Based on the etiology, the headaches are classified into two main types or Primary and Secondary headaches.
Brain tumors arise due to abnormal cell growth that normally shouldn’t be in the brain, thereby forming a mass and leading to two major types of tumors.

Tension headache

The most common type of headache is the ‘tension-type’ muscular headache that is a low pressure squeezing sensation of the forehead and temples. By definition, it can only be of moderate intensity or less. As soon as it become severe, we can’t call is a tension headache anymore and that’s almost always going to be a ‘migraine’. The location of these headaches is bi-lateral, usually around the forehead area.


Migraine headaches are the most commonly treated headache type by physicians and medical professionals across the globe. The characteristic of this headache is the gradual onset, moderate to severe intensity for the pain. Among other common symptoms (see list below) light sensitivity and nausea are often the main indicators of diagnosing migraines and differentiating it from a tension headache. Activity, bright light or loud noises can make the headache worse, so someone having a migraine often seeks out a cool, dark, quiet place.

Cluster Headache

Cluster Headache is a group of idiopathic headaches that is associated with the trigeminal nerve (face sensations). The location of the headache is always unilateral and around the eye (one sided). The pain is deep and excruciating and sometimes explosive. . One may be unable to dilate the pupils, nasal discharges etc. when such a headache persists. Duration is quick between 30min to 3 hrs. The bouts of this headache also called as cluster, and can last for months. This is followed by a period of remission where the headache usually stops occurring
Apart from these, ‘hormonal and sinus headaches’ are also prevalent.

Secondary Headache

These occur due to certain underlying conditions. Warnings signs are: illness such as cancer, age>40, previous headache history, infections to brain like encephalitis, abscess, sinus infection. The headache that arises due to these factors can be considered as abnormal. Examples include: intracranial hemorrhage, neurological disorders, thunderclap onset, temporal arteritis etc.

Signs & Symptoms

Not every headache hurts the same way. Here’s listing a few signs and symptoms that are exhibited.

Sinus headaches can have symptoms such as a runny or stuffy nose, tiredness, pain and pressure in the cheeks and forehead with increasing pressure as one may try to lie down or lean forward.

Tension headaches can be chronic or episodic. Chronic can last from 30 min to a few days and feel like they are always there. Episodic ones begin gradually, often in the middle of the day and most occur no more than 1x-2x times in a month. Typical symptoms experienced here would be tenderness in the scalp neck and shoulders, pressure in the forehead, neck and back.

Migraines generally progresses through 4 distinct stages but not everyone may experience all 4.

  1. Prodome (1-2 days before migraine) – Symptoms exhibited are: Food cravings, mood swings, increased thirst, frequent yawning, constipation
  2. Aura (Before or during a migraine- feeling of something is about to happen) About 15 to 20% of people who experience migraines have aura. – Symptoms exhibited are: visual bright spots or light flashes, photophobia, body jerks and vision loss may also occur
  3. Headache (Attack) – Symptoms exhibited are: Severe head pain in the temple areas lasting anywhere between 4-72 hrs. , Lightheadedness, 80% probability of nausea and blurred vision.
  4. Post-drome (upto a day after migraine) – Symptoms exhibited are: Confusion, moodiness and dizziness.

Causes Or Risk Factors

Specific nerves of the blood vessels get activated and send pain signals to the brain. Now what exactly caused this signal to get activated is a mystery hence we cannot pin point the exact cause of migraines or headaches in general. The causes often decide the type or category of headache one experiences. Below are listed some of the common identified causes

  • Head /Neck Trauma
  • Stress and Fatigue
  • Hunger
  • Infection in the central nervous system
  • Withdrawals – Caffeine, Drugs etc.
  • Vision changes
  • Hyperacidity
  • Weather changes
  • Certain medications that can cause swelling of blood vessels

Diagnosis and Treatment

Diagnosis of any headache depends on your medical history and the symptoms exhibited. Diagnostic test such as a CT scan, MRI, Eye Test, X-Ray (neck /sinus) can be done to determine this. There are no special tests other than these for headaches or migraines. Hence, it becomes imperative to consult a neurologist, a doctor specializing on the disorders of brain and illness for the exact diagnosis. Some preventive medication include:

  • Antiemetic (to stop vomiting)
  • Anticonvulsants
  • Simple analgesics (like paracetamol)
  • Support therapies
  • Antibiotics
  • Hot or cold compress for the head
  • Improving sleep and food habits

Migraines or any other headache is not due to a result of a serious medical condition. Only a neurologist who specialized in your symptoms can suggest alternative treatments for the recurrent state of headaches or the discomfort you may be experiencing. Talk to our doctor on +91 9503553038 | +91 9823440640 for assistance, because its not ‘just a headache’!

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