Headaches are a very common occurrence. The causes range from benign to life threatening. Examples include migraines, inflammation, stress and more serious causes such as stroke, brain tumor and high blood pressure. Headaches that are severe, unrelenting or associated with other symptoms such as fever, weakness or vision changes require a trip to the doctor. For certain conditions, like stroke and brain tumors, seeking medical care early can have a significant impact on the outcome of treatment.
This type of head pain occurs due to irritation or pinching of nerves at the base of the skull. It can be caused by injury, disk herniation or brain tumors. These types of headaches are described as throbbing, stabbing, shock-like or jabbing pain on one side of the head. Some people also note scalp tenderness and sensitivity to light. This headache can be severe in character but is not life threatening.
Treatment options include applying warm moist heat to the neck, resting in a quiet environment, neck and muscle massage and a trial of OTC medications such as ibuprofen, Tylenol or Aleve. A medical doctor may prescribe stronger pain relievers, muscle relaxants, and antidepressant or anticonvulsant medications. Other options include nerve blocks and steroid injections. Rarely is surgery needed.
Migraine headaches are among the most common causes of severe headaches and can be debilitating. These headaches may occur on the left side of the head and are described as pounding and throbbing. Additional symptoms often include nausea, vomiting, visual flashes and light sensitivity. These headaches last from 4 to 72 hours or more. Many suffer recurrent migraine headaches and require preventative medications and regular physician visits to minimize the impact on quality of life.
People often fear that a brain tumor is the cause of their headache. Pain can occur on the left side of the head depending on where the tumor is located. The skull is compact and very little room exists for expansion. Once a tumor reaches a certain size, the pressure inside the skull will increase and compression of adjacent structures occurs. This can result in head pain and neurologic symptoms such as weakness or difficulty moving or speaking.
Treatment of brain tumors is complex and depends on factors such as size, location and tumor type. Certain regions of the brain are more accessible to traditional surgical methods than others.
A stroke is a vascular catastrophe in the brain. Analogous to a heart attack, some call stroke a "brain attack". Blood flow to a region of the brain is blocked from a blood clot. The result is that a portion of the brain is deprived of oxygen and nutrients and dies. The clinical signs include headache, weakness, numbness, slurred speech and even death in some cases.
There are several things that can prevent a stroke from occurring. The main focus is on lifestyle modification: lose weight, exercise, eat wisely, limit alcohol to moderation, stop smoking and keep away from illicit drugs. Cholesterol and blood pressure require control usually through a combination of prescription medications, diet and exercise. Keeping a tight control on blood sugar levels is essential for diabetics to decrease the risk of stroke. Diets rich in fruits and vegetables can help reduce the risk as well. Persons with sleep apnea require treatment to prevent stroke and other serious health problems.
Giant cell arteritis, or temporal arteritis, is a known cause of head pain and is often felt on one side in the temple region, which can cause sharp pain in left side of head. The cause is inflammation of the lining inside an artery (blood vessel) in the head. Signs and symptoms include sharp head pain, jaw pain when eating, scalp tenderness, low-grade fever and decreased vision. Left untreated, this condition can progress to total blindness. This condition is more common in older persons and those of Scandinavian descent.
Diagnosis is made based on symptoms, lab tests and a biopsy of the inflamed artery. Corticosteroid medications taken daily by mouth can decrease the inflammation. Treatment is highly successful but steroid use is known to cause weight gain, mood swings and can result in weakening of bones. Diet and regular exercise are a good strategy to manage the side effects of treatment.
Tension headaches are felt by some experts to be the most common type of headache. In fact, around 50% of adults experience at least one headache every year. Tension headaches are often the result of stress, eye strain, lack of sleep or skipping meals. Teens are affected as well as adults. Poor posture, improper desk and workspace setup and muscle tension all contribute to the onset of tension type headaches.
Most describe tension headaches as the sensation of a band around the head or pressure-like sensation. Neck pain and shoulder tension can also be a symptom of tension headaches. Nausea and vomiting or vision changes are not part of tension headaches.
Treatment options, in addition to OTC pain relievers like Tylenol, muscle relaxation training, mediation and yoga as well as massage. Physical therapy and workspace evaluation for proper ergonomics are valuable for those that experience recurrent tension headaches. Home remedies for tension headache include ensuring adequate hydration. Some evidence exists that diets rich in Omega-3 fatty acids experience less headaches. Good sources of Omega-3 include flaxseed oil and coldwater fish.
Cluster headaches are felt on one side of the head and often are accompanied by tearing and nose congestion. Men are affected four times more often than women and the headaches occur daily for a period of several days. Attacks recur sporadically. Cluster headaches are believed to be somewhat hereditary and passed down to other family members.
Cluster headaches frequently occur two to three hours after falling asleep and generally reoccur around the same time each day. The pain is described as burning, sharp, intense and constant. Intense pain may last two hours or more and can be accompanied by eye redness, runny nose, facial flushing, excessive tearing and puffiness around the eye. Triggering factors include exertion, bright lights, hot weather, high altitude travel, smoking and alcohol or drug use.
Classic teaching suggests that breathing 100% oxygen through a mask relieves cluster headaches. It is reasonable to take OTC medications such as ibuprofen, Tylenol and naproxen at the onset of a cluster headache. Steroids, such as prednisone, can help with inflammation and pain. When used for cluster headaches, a moderate dose is started and then slowly tapered over the next few weeks. Certain medications work both in the prevention and treatment of headaches. Examples include: blood pressure medications (verapamil, propranolol), cyproheptadine, antidepressants (amitriptyline) and antiseizure medication (topiramate and valporic acid). Narcotic medications are less effective in treating headaches in general and are known to cause a rebound in pain.
Certain features of a headache should cause concern. Most of us have experienced a headache at least once in our lives. Headaches that begin after the age of 50 should prompt concern. Ruptured cerebral aneurysms (blood vessels) are most common in women around the age of 50. A sudden onset maximal intensity headache in persons of this age requires a medical evaluation. Headaches that are changing in pattern or frequency or that are becoming steadily worse should be discussed with a doctor. Other concerning features include: headaches along with a red eye, headaches that accompany behavior or cognitive changes, headaches along with soreness in the temple area or jaw, and headaches that occur after trauma or a blow to the head.