File headache

Headache is so common that nobody is surprised. Every day tens of millions of people in the world suffer from headaches and 90% of the Dutch sometimes have a headache. The pain is in many cases harmless and short-lived, but that does not apply to all headaches. Migraine eliminates you and sinus headache can last for months. Painkillers often work poorly or not at all and a visit to the doctor often only provides the diagnosis of 'stress'. What is 'your' headache?

Headache general

Almost everyone knows the headache phenomenon. Sometimes it takes one or more days and it stays with a somewhat nagging feeling where you can still function. It can also take on a worse form, so that you have to stop your daily activities. With migraine you are even forced to lie down, preferably in a darkened room, until the attack is over. And there are many forms of headache that fortunately rarely result from something serious.
Most headaches occur on the outside of the skull, in the nerves, blood vessels and muscles that cover the head and neck. The muscles or blood vessels can swell, contract or undergo other changes that can stimulate and stimulate the surrounding nerves. The nerves come under pressure and send pain signals to the brain, after which a headache arises.

Tension headache

Tension headache is actually a collective term for all headaches that a doctor knows nothing about. The actual tension headache is distributed symmetrically over the head and often it feels like there is a tight band (or helmet) around the head. The pain is dull and oppressive and moderate in intensity. It does not affect daily activities and the duration is variable. What happens is that muscles of the skull, neck and shoulders are tense. This type of headache is actually a kind of 'muscle pain'. In particular, the sternocleidomastoid muscle on the side of the neck can, if it contains trigger points (painful muscle nodes), send a 'referred pain' to the forehead. Incorrectly, most headache cases are attributed to psychological stress.

Migraine

Migraine is a throbbing or throbbing headache that completely eliminates you. A migraine attack has a clear beginning and end. The very stressful pain is often on one side of the head and comes up slowly. The duration of migraine is variable and can range from half a day to three days. Headache associated with nausea, vomiting and / or diarrhea is in most cases migraine. Migraine can announce itself a few hours to days before the attack by means of complaints such as mood changes, loss of concentration, yawning, overactivity or inactivity and feel like sweets. This is called the warning phase. Some people report getting migraines from certain foods. In the case of migraine, it is important to find and prevent any triggers.

Aura in migraine

Fifteen percent of migraine patients have neurological symptoms that eventually herald the attack. This is also called migraine with aura. Such an aura lasts from ten minutes to an hour and can consist of visual disturbances such as vision loss, blurred vision, seeing flashes of light, glare, asterisks, spots, or a point of vision that can expand. There are also disturbances in the smell, tingling on one side of the body, loss of strength, speech disorders and fatigue. All in all very frightening symptoms. Once the migraine has begun, the patient searches for an obscured room and cannot do much else until the attack is over. Once the attack is over, the patient often remains very tired for hours or days. By the way, an aura can also occur on its own, without the migraine.

Cause of migraine

Classical migraine still has a number of symptoms, such as distortions in hearing and seeing, difficulty concentrating, listening and speaking, time shifts and déjà-vu's, fever, cold limbs, shivers and sweating and a temporarily accelerated heartbeat followed by a slow heartbeat. All these symptoms can occur if the attack is started. Little is known about the precise cause of migraine, but it is assumed that the attacks are triggered by a disruption of the nervous system, after which blood vessels in the head first narrow and then expand rapidly. The narrowing would then cause the aura and the dilation the headache itself.

What to do with migraine

There are medicines for migraine, but these are only given if acetaminophen or ibuprofen do not work. It is best to take the medication for the very first symptoms in order to suppress an attack. If you take your painkillers too late, they will not work. For women, pill use can trigger migraine attacks or even auras without a migraine (!). It is therefore better to stop these drugs instead of taking medicines against migraine.

Hormonal headache

This headache usually occurs on the first day of menstruation and can range from light to so heavy that it looks more like a migraine. The sharply decreased hormone level before and during menstruation is responsible for this. In any case, the strongly fluctuating hormone levels (estrogen) can lead to headaches. Headaches may occur in the two weeks prior to menstruation as part of PMS (premenstrual syndrome), this is usually of highly variable duration and not severe.

Weekend headache

This is the so-called relaxation headache that is naturally very easy to prevent. After a busy working week, people sleep late on Saturday and when they get up there is the overpowering headache. This headache is a result of a lack of caffeine (coffee), which comes later in the weekend than during the week, and a disruption of the sleep pattern.

Sinus headache

The real sinus infection and / or forehead cavity inflammation gives immense headache when bending over. This headache is more between the eyes, at the level of the forehead and in the cheek area near the nose. The cavities do not have to be bacterially inflamed, but can also simply be blocked, for example with a virus infection such as a (nose) cold. Stuffed nose and throat tonsils can also cause headaches because they obstruct aeration. Sinus headache can last for weeks to months, and is often incorrectly placed under the banner of stress and tension because the sinus cavities on X-rays are 'clean' in most cases. In case of sinusitis, in addition to headache, there is also a severe malaise.

Medicine-dependent headache

This headache occurs with addiction and / or habituation to drugs that are actually taken against headache. Over time, the body no longer responds or responds badly to this drug, unless it is not taken, which in turn increases the headache. Long-term painkillers are therefore not recommended. A paracetamol per day for three months can be the start of a chronic headache that is difficult to get rid of. Rehabilitation of this drug-dependent headache is long-term and heavy, but is necessary to eventually reduce the headache. This form of headache can already occur with addiction to simple painkillers such as aspirin and paracetamol, but also by triptans prescribed for migraine.

Cluster headache

This is a very specific and almost unbearable headache in the form of attacks (clusters) on one side of the head. It is a vascular headache, which means that it concerns the blood vessels. The fortunately rare pain is so fierce that it can feel like a dagger is stabbed through the eye, but it can also be a drilling pain. It is more common in men than in women. The duration of the episodes in which the attacks occur is variable and can range from a few weeks to a few months. The attack itself lasts from a few minutes to a few hours and can occur several times a day. The pain develops very suddenly, often during sleep, and starts behind and around an eye or close to sleep and then radiates to the upper jaw, ear, neck and area around the eye. The eye turns red and tears and the nose feels clogged or starts to walk. There is also an urge to move and excessive perspiration. After the attack, the pain is completely gone or a nagging pain remains, which can be re-triggered.

Furthermore, headache can occur with:

  • Skip meal (s)
  • Bad sight
  • In a poorly ventilated area
  • Dehydration
  • Long journey in bus, car or plane
  • Smelling very strong scents
  • Dental and jaw problems
  • Flu or other diseases where there is a fever
  • Low blood sugar in diabetics
  • Chronic lack of sleep
  • Long-term efforts
  • The 'hangover' after excessive alcohol consumption
  • Sudden temperature drop
  • Very high blood pressure
  • After sex
  • Problems in the neck

Headache that requires consultation of a doctor:

  • Headache after an accident
  • A severe headache that you have never had before
  • Suddenly intense headache with very sick feeling or explosive vomiting
  • Severe headache during pregnancy
  • Headache with lowered consciousness, extremely stiff neck or convulsions
  • Headache with change of personality
  • Headache in children under six years old
  • First migraine attack at age 40+
  • Headache that occurs at 50+ and is new to the patient
  • Headache with functional disorders of the nervous system such as double vision or paralysis
  • Headache in children that affects performance
  • Headache with unilateral deafness and / or dizziness

"I thought so hard I got a headache." ~ J.D. Cobb

Video: How do you get rid of a headache at school ? Health and Life (February 2020).

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