Headache: what makes a headache serious?

Headaches are very common and have many causes. Although they are a frequent source of stress and anxiety, headaches are only very rarely a sign of serious illness. Many headache sufferers worry about having a brain tumour, but this is a very uncommon event. There are many different types of headaches, including tension headaches, sinus headaches, migraine headaches and cluster headaches.

Tension headaches

The most common cause of pain in the head is tension headache. According to the World Health Organization, this type of headache affects about two-thirds of all men and about 80% of all women in developed countries. These headaches are usually felt as a dull pain on both sides of the head, or as a feeling of having a tight band around the forehead. They usually appear around times of stress. They may come on with tiredness and sometimes after prolonged reading. Taking exercise or drinking alcohol does not usually make these headaches any worse.

Tension headaches are thought to be due to contraction (tightening) of the neck muscles. Simple over-the-counter painkillers such as aspirin or paracetamol usually relieve these headaches. Hot showers and massage may also help. Chronic sufferers should beware of becoming too reliant on painkillers and look for ways of relaxing and avoiding stress.

Sinus headaches

Sinus headache is a common problem, which many people will recognise, particularly when they have a bad cold or flu. A ‘stuffy’ head and pain above or behind the eyes, or on either side of the nose, are the usual symptoms. Pain is often worse when the head is bent forward.

Migraine headaches

Migraine is a common cause of headache, affecting 6 to 8 per cent of men and 15 to 18 per cent of women each year. This problem is thought to be due to changes in blood flow through the brain. The headache is often throbbing, one-sided, associated with nausea (feeling sick) and vomiting, and worse with bright light and noise.

Specific treatments are available for migraine. Many attacks, if recognised in their early stages, will disappear if you take a simple painkiller and lie down in a dark, quiet place.

Cluster headaches

Rather similar to migraines are cluster headaches. These are one sided, usually around the eye. There may be a feeling of a blocked nose and a watery eye. They are a rare type of headache, affecting men more than women. They can be brought on by alcohol. They may occur frequently for a few days (in a ‘cluster’) then they may disappear for weeks or months.

When to see your doctor

Despite this wide variety of non-serious headaches, sometimes a headache will be a sign of serious disease. See your doctor if any of the following applies to you:

  • you start getting regular headaches and you are aged 50 years or over;
  • you get a sudden severe headache ‘out of the blue’ that may be accompanied by a stiff neck;
  • you have a constant headache that is gradually getting worse over days or weeks;
  • you develop a severe headache accompanied by fever, nausea or vomiting that isn’t related to another illness;
  • you have a headache together with drowsiness, confusion, or memory loss;
  • you have a headache following a head injury;
  • you have a headache together with loss of sensation or weakness in any part of your body;
  • you have two or more headaches in a week;
  • you have a headache associated with being short of breath; or
  • you develop a headache that is associated with convulsions (fits).

 
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