Headache

HEADACHEs
BRIDGE THE GAP TO YOUR DIAGNOSIS AND MANAGEMENT 

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Did you know this about headaches?

  

Headache is the second most disabling chronic illness in the developed world (WHO). It is very common and can be due to any of the pure headache disorders or caused by something else. While most people will suffer with occasional episodes of headache, usually Tension Headache or Migraine, a new persistent or frequent headache, can be disabling and worrying. 

The key to managing headache is to have a clear diagnosis of the headache disorder, for example Migraine. It is unusual for non-specialists to make a clear headache diagnosis, and even in an Emergency Department setting within the NHS, only 20% of patients are given a clear diagnosis. 
MRI of brain : brain injury
In evaluating your headache, your neurologist/headache specialist will look for any Red-flag features, diagnostic features for a pure headache disorder (Primary Headache – e.g. migraine, cluster headache), and do any appropriate investigations. Most people with headache don’t have anything pathological other than the headache. Neuroimaging for patients with this diagnosis is usually normal, which means no brain tumours, or bleeds, or brain malformations.

Tension headache is the most common headache disorder, followed by Migraine.

Medication overuse headache is a common and easily missed diagnosis. A person overusing paracetamol, opiates, or sometimes NSAIDS (Ibuprofen, Aspirin, Naproxen etc) can quickly develop a headache which is partially relieved for a short time by taking more tablets.

Headaches to be concerned about are any with other neurological features beyond pain (eg visual changes, ), if they are new or changed, associated with personality changes or seizures, or features suggesting high pressure inside the skull (headache worse lying down, worse with cough/strain, visual obscuration, nausea/vomiting on wakening).

Headache can lead to many days of missed work, cancellation of social activity, inability to engage with family life, and feeling unable to live life normally. There are not often immediate solutions once a headache disorder is diagnosed, but getting on the right track early can get control faster, thus ensuring you get your life back sooner rather than later.

If you are getting headaches frequently, fill in a Headache Diary. Many are available as Apps or downloads, but for a doctor the best is a Month to View simple diary like the one I have attached here

Some other useful links include:
www.bash.org.uk (British Association for the Study of Headache)
www.ouchuk.org (Cluster Headache)

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