THE COMMON BANE OF HEAD PAIN

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THE COMMON BANE OF HEAD PAIN
www.shreyahospital.in
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Headache is one of the most common disorders seen
to occur in all age groups but much more so in
women. Broadly headaches can be classified as
Primary and Secondary Headaches disorders.
Primary Headache disorders have no apparent
causative factor and are thought to be interplay
between genetic predisposition and environmental
provocative factors. The most common by far is
Migraine. Secondary headaches are those that
result from a cause e.g. Brain Tumor. The
Primary Headaches Migraine Tension-type headache
Cluster headache and other trigeminal autonomic
cephalalgias Other primary headaches. The
Secondary Headaches Headache attributed to head
and/or neck trauma Headache attributed to cranial
or cervical vascular disorder Headache attributed
to non vascular intracranial disorder Headache
attributed to a substance or its withdrawal
Headache attributed to infection Headache
attributed to disorder of homoeostasis Headache
or facial pain attributed to disorder of cranium,
neck, eyes, ears, nose, sinuses, teeth, mouth or
other facial structures. Headache attributed to
psychiatric disorder.
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Cranial Neuralgias, Central and primary facial
pain and other headaches Cranial neuralgias and
central causes of facial pain Other headache,
cranial neuralgia, central or primary facial
painFor all practical purposes, most people
suffering from headaches have primary headache
disorders especially Migraine. Though most people
worry that they may have a Brain Tumor or
serious disease causing headache that is a rare
and an unusual situation. Certain Red flags can
help and decide if the headache cause could be of
a dangerous origin. Workisome Headache Red Flags
Snoop Systematic symptoms (Fever, weight loss)
or secondary risk factors (HIV, Systematic
cancer)Neurologic symptoms or abnormal signs
(confusion, impaired alertness or
consciousness)Onset Sudden, abrupt or spilt
second Older New onset and progressive
headache, especially in middle age gt 50 (Giant
cell arteritis) Previous headache history 
First headache or different (change in attack
frequency, severity or clinical features)There is
also an incorrect belief that the word migraine
would always implies a very severe headache. That
is incorrect and most headaches suffered by
people in the world are Migraine. Migraine is a
spectrum of headaches that could be mild and
infrequent or severe, frequent and daily.
Migraine with aura (usually visual symptoms) is
also called Classic migraine and occurs in 15
patients. Migraine without aura (also called
Common Migraine) occurs in 85 patients.
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Common Symptoms of Migraine Head pain (Pounding,
pulsating, throbbing) Nausea/Vomiting Loss of
appetite Light or sound sensitivity
(Sonophotophobia) Scalp tenderness Dizziness and
lightheadedness  Irritability. Common
Aggravating Causes of Migraine are Sleep
deprivation Excess or lack Irregularity of 
meal times Stress Hormonal changes Food
triggersThe management of headaches begins by
establishing the correct diagnosis clinically or
with the help of tests ruling out the rare but
dangerous secondary headache disorders. Once it
is established that underlying condition is
migraine than the treatment has the following
steps
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Lifestyle management - to recognize and eliminate
aggravating factors.  Preventive therapy  Daily
medications of various types which are used to
prevent/reduce the number of attacks of
headache. These are not Rescue (immediate/SOS)
pain relieving medicines and must be taken
regularly for 3- 6 months or more. Rescue
therapy To abort the attack of severe
headache.It is important to recognize and
appropriately deal with these disabling headaches
to prevent Medicine Overuse Headache (MOH) which
occurs in many people who chose only to take
Acute/Abortive/Rescue medications. Painkiller
over use can also result in Ulcer disease and
kidney dysfunction.  For patients in whom
headaches have worsened to a point where they
have incapacitating near daily headaches. Newer
modalities of therapy like Botox are
available. Key points Recognize that most
headache are Migraine and not Gas, Weak eyes
or Sinus. Migraine does not imply only severe
debilitating headaches.  Practically most
headaches is the world are Migraine. Prevent MOH
and side effects of rescue medications. Recognize
CDH (Chronic daily headache) and consider newer
modalities of treatment such as Botox. 
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Hospital In Shalimar Garden, Ghaziabad in India.
It Is One Of The Most Technologically Advanced
Healthcare Diagnostic Centers. Website
Website http//shreyahospital.in/ent/ Plot No.
837, Shalimar Garden, Ext-ISahibabad, Ghaziabad
201005 (U.P.)Phone [phone]E- Mail
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