Headache and its management

         
           A headache is a term given for the symptoms of pain in and around the head and neck region. It is the most common problem between the age group of 20 to 40 years. Some common causes of a headache are fatigue, sleep deprivation, stress,etc.,

 TYPES OF A HEADACHE

• A primary headache
• A secondary headache

A PRIMARY HEADACHE

         It occurs without involving any secondary causes. This category includes

•  A migraine
•  A tension-type headache
•  Caffeine withdrawal headache

A SECONDARY HEADACHE

         A headache which occurs due to other causes of head injury, brain tumours, increased intracranial pressure,etc.,

1) A migraine headache

• It is a pulsing type headache.
• It has some associated symptoms like nausea, vomiting, sensitive to sound and smell, photophobic.
• It worsens with increased physical activity.

MANAGEMENT OF A MIGRAINE HEADACHE:

• Take bed rest and avoid noisy sound and direct light.
• Medications like beta blockers, non-steroidal anti-inflammatory drugs(NSAIDs), anti-depression drugs and acetaminophen.

example:

• beta blockers - propranolol
• NSAIDs - ibuprofen
• anti-depression - amitriptyline
• acetaminophen - paracetamol

2) A TENSION-TYPE HEADACHE:

• It is a non-pulsing headache.
• The pain radiates from head to other areas.
• The pain is a band like on two sides of the forehead.
• No other symptoms will be present.

MANAGEMENT OF A TENSION HEADACHE:

• Take rest and sleep well, if not relieved than taking ibuprofen, anti-depression drugs, paracetamol.(according to the presenting symptoms)

3) CAFFEINE WITHDRAWAL HEADACHE:

          Normally, the brain consumes energy from the ATP and the ATP is converted to ADP. The adenosine is split from the ADP by the degrading enzymes. During waking, the brain consumes more energy and the level of adenosine accumulation is high in the brain neuronal cells and the neuronal activity is slow down. The increased activity of adenosine will make the brain sleepy and we go to sleep.

         The caffeine competes with the adenosine receptors and the action of adenosine is reduced and the caffeine which induces the signal transmitter to secrete a required level of adrenaline which makes the neuronal cells to work at its peak level and the brain becomes brisk and awake.

         In case, if caffeine intake is stopped and the withdrawal symptoms like a headache will occur. The mechanism is due to increased sensitivity; the level of adenosine is inadequate to make the brain sleepy. The adequate amount of sleepy state is needed for the brain during recovery phase to replenish the energy level like ATP. Due to this, we will experience the caffeine-related withdrawal headache.

          For further reference, please consult your family physician.