Headache Disorders are important and common conditions that cause significant suffering to patients. Most headaches are not caused by serious conditions, but headache symptoms need to be diagnosed and treated by specialists because headaches can also be a warning sign of serious diseases. Generally,
Patients often experience headaches due to the following causes
- Tension-type headache
- Migraine headache
- Cluster headache
- Chronic daily headache
Tension-type headache
Tension-type headache is the most common headache disorder, often occurring in individuals who are stressed, tired, or overworked. The pain is usually described as tight or pressing on both sides of the head and neck. The pain severity is usually mild to moderate and may be accompanied by muscle pain in the head, neck, and shoulders. This type of headache does not worsen with daily activities and usually does not involve nausea or vomiting.
Migraine headache
Migraine is a common headache disorder that is often misdiagnosed. It is frequently found in working-age women. The pain is usually moderate to severe and can be worsened by external stimuli such as light, sound, or smell. Some patients may experience nausea and vomiting. Most migraines last at least 4 hours, and in some cases, the pain can last up to 3 days.
Cluster headache
Cluster headache is an uncommon headache disorder but can cause severe suffering if not properly diagnosed and treated. It occurs more often in men than women. The pain is severe and causes restlessness. It usually starts suddenly and lasts from 15 minutes to 3 hours. The pain is typically located around the eye or temple and is usually one-sided. Patients may also have parasympathetic nervous system symptoms such as red eyes, tearing, runny nose, and sweating on the side of the face where the headache occurs.
Chronic daily headache
These patients usually have chronic headaches more than 15 days per month for at least 3 months. The headache may be tension-type or migraine, but the symptoms are more persistent. Some patients in this group may have medication overuse headache caused by misdiagnosis, self-medication, or frequent use of painkillers, which leads to worsening chronic headaches. Other causes of headaches include sinusitis, stroke, subarachnoid hemorrhage, cancer, etc. Diagnosis requires detailed history taking, physical examination, and additional tests such as MRI to help differentiate dangerous conditions.
Warning signs of headache conditions
Although most headaches are not caused by serious diseases, patients with the following headache symptoms should urgently see a doctor as they may be caused by life-threatening conditions such as brain hemorrhage or infections of the nervous system. Warning signs of headache include:
- Sudden severe headache
- Headache accompanied by fever and stiff neck
- Headache with abnormal neurological symptoms such as weakness in limbs, confusion, personality changes, etc.
- Headache in patients with cancer or HIV infection
- Headache that progressively worsens and does not respond to treatment
If patients have these symptoms, they need urgent diagnostic evaluation, which will lead to appropriate and timely treatment.
Summary: Headache is a common symptom that requires detailed history taking, physical examination, and additional diagnostic tests in some patients to achieve accurate diagnosis and effective treatment.
Dr. Bancha Siemhan
Neurologist
Brain and Spine Center, Phyathai 2 Hospital
