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Headache, migraine treatment

Headache is one of the most common health complaints leading to a doctor’s appointment. Two major categories can be differentiated: related to other disorders, so called symptomatic headache types, and the separate, primary headache disorders.

What other disorders can be linked to headache?

  • high blood pressure

(in cases of frequent headache, especially if high blood pressure runs in the family, checking blood pressure is worthwhile, considering the role of high blood pressure in the manifestation of severe cardiovascular complications.)

  • sinusitis, inflammation of the paranasal and frontal sinuses

(in cases of symptoms developing after flu-like, catarrhal illness, defined by pain in face or forehead area worsening when bending forwards, seeing a doctor is recommended in order to receive a prescription for antibiotics, if necessary)

  • fever
  • glaucoma
  • cervical spine lesions
  • dental root and gingival problems
  • neuralgia
  • tumor
  • cerebral hemorrhage

Which cases of headache require immediate medical assistance, when to call the ambulance?

  • If it occurs suddenly, hammering, intense, profuse
  • if consciousness is impaired
  • if it aggravates gradually, associated with sudden vomiting without any nausea
  • if it is associated with facial asymmetry, inability to move

Primary headache

The tension-type headache bilateral, pressuring, clamping. Usually well managable with prescription free pain-killers.

The cluster headache severe, unilateral pain of the peri-ocular (around the eyes) or temporal area, which lasts from 15 minutes up to 3 hours, occurring at least every other day or several times a day. It may be accompanied by redness of the eyes, lacrimation, sweating, and swelling of the eyelids. Treatment of the attack is a medical task, as far as prevention it needs to be emphasized to avoid provoking factors: alcohol, warm bath, food containing high levels of histamine: sea fruit, salty water fish, nuts and hazelnuts.

The migraine occurring in form of recurrent attacks, which persist for 4 to 72 hours. Pulsating, unilateral, intense pain. May be accompanied by nausea, vomiting photophobia.

May be associated with a so called introductory phase in the 24 hours preceding the attack, defined by highly diverse symptoms, irritability or even unmotivated good mood may be seen. The phase directly preceding the attack is the aura, during which the patient is seeing bright spots, zigzag lines, this phase, however, doesn’t occur with every migraine attack.

Can the migraine attack be prevented?

There are certain provoking factors, which may result in a migraine attack, these should be avoided by those vulnerable to migraine.

  • Stress
  • red wine
  • certain cheese types
  • preservatives containing nitrite and nitrate
  • chocolate
  • contraceptives

Migraine treatment constitutes a major challenge to the medical community. Therapy always needs to be aligned to other co-morbidities of the patient, considering acute attack treatment as well as maintenance therapy between the attacks. Effective treatment usually proves to be unique for each individual patient. If nothing else available, prescription free agents may be tried, keeping in mind that drugs with different brand names often contain the same active agent, thus attention is needed to avoid overdosing of a certain medication.

Headache ambulances: