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For
the past year and a half, Chris, a successful electronics technician,
suffered with excruciating headaches. Night after night he awoke
after only 1 or 2 hours of sleep and spent the rest of the night
hoping his head would quit hurting.
After
several visits to his doctor and a complete work-up, the proper
combination of medicines, diet, and exercises was found. Chris finally
got relief from his greatest nemesis, the headache.
An
estimated 45 million Americans experience chronic headaches. For
at least half of these people, the problem is severe and sometimes
disabling. It can also be costly: headache sufferers make over 8
million visits a year to doctor's offices. Migraine victims alone
lose over 157 million workdays because of headache pain.
Why
Does Your Head Hurt?
Where
is the pain coming from when you have a headache? Several areas
of the head can hurt, including a network of nerves that extends
over the scalp and certain nerves in the face, mouth, and even the
throat.
Also
sensitive to pain, are the muscles of the head and blood vessels
found along the surface and at the base of the brain, which are
rich in delicate nerve fibers. However, because they lack pain-sensitive
nerve fibers, the bones of the skull and tissues of the brain itself,
never hurt.
The
ends of these pain-sensitive nerves, called nociceptors, can be
stimulated by stress, muscular tension, dilated blood vessels, and
other triggers of headache. Once stimulated, a nociceptor sends
a message up the length of the nerve fiber to the nerve cells in
the brain, signaling that a part of the body hurts.
A number
of chemicals help transmit pain-related information to the brain.
Some of these chemicals are natural painkilling proteins called
endorphins. One theory suggests that people who suffer from severe
headache and other types of chronic pain have lower levels of endorphins
than do people who are generally pain free.
When
Should You See a Physician?
Not
all headaches require medical attention. Some result from overused
neck muscles, for example, or occasional muscle tension and are
easily remedied. But some types of headache are signals of more
serious disorders, and call for prompt medical attention. These
include:
- Sudden,
severe headache
- Headache
associated with convulsions
- Headache
accompanied by confusion or loss of consciousness
- Headache
following a blow on the head
- Headache
associated with pain in the eye or ear
- Persistent
headache in a person who was previously headache free
- Recurring
headache in children
- Headache
associated with fever
- Headache
which interferes with normal life
What
Tests Are Used to Diagnose Headache?
Diagnosing
a headache begins with a detailed question-and-answer session with
the patient and can often produce enough information for the diagnosis.
Many types of headaches have clear-cut symptoms which fall into
an easily recognizable pattern. Most physicians will also obtain
a full medical history from the patient, inquiring about past head
trauma or surgery and about the use of medications and may suggest
that a patient undergo a computed
tomographic (CT) scan and/or magnetic
resonance imaging (MRI). The CT scan produces images
of the brain that show structures or variations in the density of
different types of tissue. The scan enables the physician to distinguish,
for example, between a bleeding blood vessel in the brain and a
brain tumor, and is an important diagnostic tool in cases of headache
associated with brain lesions or other serious disease. A physician
analyzes the results of all these diagnostic tests along with a
patient's medical history in order to arrive at a diagnosis.
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Headaches
are diagnosed and classified into the following types:
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- Vascular
- Muscle
contraction (tension)
- Traction
- Inflammatory
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Vascular
headaches -- a group that includes the well-known migraine--are
so named because they are thought to involve abnormal function of
the brain's blood vessels or vascular system. Muscle contraction
headaches appear to involve the tightening or tensing of facial
and neck muscles. Traction and inflammatory headaches are symptoms
of other disorders, ranging from stroke to sinus infection. Some
people have more than one type of headache.
Learn
about Migraines
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