Headaches

Headaches are very common. Everyone has experienced a headache at one point or other in their lives but if you are experiencing more frequent or more severe headaches, you should seek medical advice to exclude anything serious and learn how to manage your condition.

Some serious causes of persistent headaches that need to be excluded include inflammation in the blood vessels in the brain, stroke, infections, tumours, traumatic brain injury and changes in intracranial pressure. Once these have been excluded, a careful history and examination would often indicate the type of headache and the most appropriate management.

Some common types of headaches are outlined below. Patients may experience more than one type of headache. 

Tension headaches feel like a tight band or pressure around the head and are caused by contraction or spasm of the muscle around the skull. These types of headaches are sometimes associated with neck pain and stiffness and are usually aggravated by stress and anxiety.

Migraines are more severe headaches which may be associated with nausea and vomiting as well as sensitivity to light and sound. These types of headaches often run in families and are sometimes preceded by an aura which is a sensory or visual disturbance occurring minutes before onset of the headache.

Cluster headaches feel as if someone is tearing one’s eye out with a chisel. They occur in clusters, that is for periods of weeks and this may be followed by months or even years of no headaches. Commoner in men, they can be debilitating but medication can help.

Sinus headaches occur when there is congestion in the sinuses following allergy or infection. Accurate diagnosis is the key to getting prompt, appropriate treatment as symptoms resolve very quickly once this is started.

Rebound headaches occur in patients who take painkillers frequently for minor aches and pains. The body develops tolerance to these painkillers and stopping them can cause headaches.

The Consultation

A 1-hour slot is allocated for patients presenting for the first time with headaches. The patient will be asked about the symptoms experienced and if a diagnosis has already been established. The doctor will ask about medications tried in the past and about any therapy sessions that the patient may have attended. The patient’s history is explored, focusing on possible triggers and aggravating factors. Throughout the meeting, the patient’s symptoms and concerns are addressed, ensuring that everything is understood clearly.

After the interview, the doctor would be able to provide the most probable diagnosis and discuss the necessary steps needed to manage the symptoms. Further investigations may be necessary in some cases and the doctor will advise on how to have these carried out at Mater Dei Hospital or in a private hospital.

The doctor would then compile a medical report with a treatment plan for the patient. This often includes some lifestyle changes which can help reduce the pain and optimize the response to treatment. Nutritional supplements are recommended when necessary and various medication options are discussed.