Headache

Headache is a fairly common complaint. However, it is important to recognize the more serious types of headaches that are actually symptoms of more serious diseases. Common Types of Headaches

Tension headache:

The most common form with 'tight band' especially over the temples. Associated with contractions of head and neck muscles due to physical or mental stress. May be aggravated by changes in the environment, drugs, or factors unique to the individual. Treatment is by simple painkillers, rest and removal of aggravating factors.

Migraine:

There is a heavy throbbing pain usually over one side of the scalp, forehead and about the eye, caused by abnormally dilated blood vessels. May be accompanied by nausea, vomiting or sensitivity to loud noises or bright lights. Known to be triggered by certain factors unique to the individual such as menstruation, alcohol or anxiety. Treatment is by special anti-migraine drugs that reduce the dilatation of blood vessels and painkillers together with resting in a cool, dark and quiet room. Solving the triggering factors also help.

Cluster headaches:

More common in males. It occurs in runs with tearing pain over the forehead or behind the eye(s) with flushing of the face. Associated with alcohol consumption. Treatment is by strong painkillers and rest.

Sinus headaches:

Fairly common during acute sinus inflammation attacks. Pain is over the frontal forehead and the upper cheeks. Associated with fever and heavy mucus production. Treatment is by antibiotics for the sinus infection, antihistamines to reduce mucus production and painkillers.

Referred headaches:

These are caused by disorders of structures around the head. Common ones are earaches, toothache causing pain over an entire part of the face and temporomandibular joint dysfunction from mechanical pain from the jaw joint. Rarer causes include a rare blood vessel disease on the temples called temporal arteritis and other autoimmune diseases of the nervous system.

Serious Types of Headaches

These types of headaches are less common but should be recognized as they are potentially life-threatening.

Meningitis / Encephalitis headaches:

Caused by infection of the brain tissue (encephalitis) or the membranes surrounding the brain (meningitis). Can be caused by viruses, bacteria, parasites or poisons. Typically presents as a painful stiff neck with fever and other symptoms such as drowsiness, seizures and neurological problems including weakness and numbness. Needs immediate hospital treatment.

Cerebrovascular Accidents (haemorrhagic stroke):

One of the top killers in Singapore, a stroke happens when a blood vessel in the brain is blocked or bursts. Bleeding in the brain causes a sudden severe headache. There is also loss of consciousness and other neurological signs such as weakness, numbness and seizures. Needs immediate hospital treatment.

Brain Tumours:

It is rare. It is a gradual headache lasting for weeks, worse especially at night or early morning. Accompanied with nausea, vomiting, loss of appetite and loss of weight. By the time neurological symptoms appear such as seizures, numbness, weakness or blindness, the brain tumour has already grown to an advanced stage. Treatment includes surgery, chemotherapy or radiotherapy.

Treatment

What you can do