IS IT JUST HEADACHE?

               We were having an interesting conversation, when suddenly she covered her eyes and leaned towards the door of the car. In place, of the smile on her face was a grimace.  Leaning forwards from the backseat, I stretched my hand towards her, asking “Hey, are you okay?”. “I have this pain on the right side of my head, that keeps coming and going, and it makes me nauseous.” she replied. “I will be okay”, she added. In a few minutes, she had begun to feel better and she was laughing at my jokes once more, when I alighted at my stop. What could have gone wrong? Was it serious? Should she be worried?

                Headaches are an almost constant feature in our everyday lives. One in every two adults is likely to experience at least one episode of headache in a year. It is the most commonly given health excuse, “oh, I don’t feel too good, I have a headache”, to get out of that boring conversation, lecture or meeting. But could it be just headache? Or could it portend something more sinister. The “International headache Society” (no kidding, this actually exists) classifies headaches into primary or secondary. The Primary headaches have unknown causative factors and are mostly benign, while the secondary headaches have causes that could be pinpointed and these should be treated with caution.

                The common types of primary headaches include the tension type headache, the migraine and the cluster headache amongst others. The tension type headache is usually described as a mild or moderate dull pain lasting 30 minutes to several hours, with the pain likened to a tightness or band around the head. Migraines are described as throbbing, moderate or severely painful, lasting a few hours to some days, occurring periodically, sometimes associated with nausea and vomiting, sensitive to bright lights and loud noises. People having migraines tend to prefer staying in dark, quiet rooms. Cluster headaches are commonly described as a sharp pain, located on one side of the head or face, lasting from 30 minutes to a few hours and associated with running noses or teary eyes. Other primary headaches could be linked to exertion (primary exertional headache), sexual activity (primary sexual headache), coughing (primary cough headache) and sleep (hypnic headaches). However, these types of primary headaches are rare.

                Headache could however have more sinister causes and these are usually grouped as secondary headaches. The headache could be caused by inflammation of the covering of the brain (meningitis), bleeding into the brain (intracranial haemorrhage), a brain tumour or increased pressure in the eye due to acute angle glaucoma. The causes of secondary headaches are legion. However, the key is to be able to recognise that a “headache” is actually more than just headache and would require expert intervention.

                There are red flags that everyone suffering from a headache should look out for. These include, fever or weight loss, a new episode of headache in someone suffering from a chronic disease such as cancer or HIV, headache in someone older than fifty, headache of sudden onset, headache accompanied by weakness or inability to move any limb, headache associated with personality or behavioural changes and headache following injury to the head. A medical personnel preferably a specialist (neurologist) should be consulted. This is not the type of headache to be treated at home by self-medication. Visit the nearest hospital! Also, individuals suffering from “supposed” primary headaches should visit a hospital if there is no noticeable improvement after some days.

                My gut tells me the lady mentioned earlier possibly had a migraine headache. But, I advised her to take some analgesics and observe plenty of rest, she was also to visit the nearest hospital if symptoms worsened.

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