Headache

Symptoms

DEFINITION

• Pain or discomfort of the scalp or forehead areas
• The face and ears are excluded

Common Causes

• During the course of a year, the majority of adults suffer headaches.
• Muscle Tension Headaches: The majority of headaches are caused by muscle tension. The discomfort is usually diffuse and may radiate down into the neck and shoulders. The discomfort is aggravated by emotional stress.
• Migraine Headaches: Also referred to as vascular headaches. The headache is moderate to severe in intensity, described as throbbing or pulsing in nature, and usually unilateral. Associated symptoms include nausea and vomiting. Some individuals will have visual warning symptoms (aura) that a migraine is coming.
• Sinusitis: Headaches occur with sinusitis. The headache is usually located in the forehead area and the individual has associated sinus symptoms (nasal discharge, congestion).
• Fever: A mild to moderate headache frequently accompanies the fever that occurs with common viral infections such as the flu and the common cold. A severe headache that persists after the fever has come down to normal is a red flag that something more serious may be causing the headache.
• Caffeine Withdrawal: This occurs in individuals who drink large amounts of caffeine (e.g., coffee, tea, colas) and suddenly stop. Some caffeine drinkers will note a headache upon arising that goes away after their first cup of coffee.

Some Serious Causes of Headache

• Stroke ("Brain Attack")
• Meningitis, encephalitis
• Temporal arteritis
• Brain tumor
• Carbon monoxide exposure

See More Appropriate Topic (instead of this one) If

• Headache followed a head injury, see HEAD INJURY
• SINUS PAIN AND CONGESTION

Should I Call?

WHEN TO CALL YOUR DOCTOR

Care at Home

HOME CARE ADVICE FOR HEADACHE

1. Migraine Headaches:
   • Migraine headaches are also called vascular headaches. A migraine can be anywhere from mild to severely painful. Sufferers often describe it as throbbing or pulsing. It is often just on one side.
   • Associated symptoms include nausea and vomiting. Some individuals will have visual or other neurological warning symptoms (aura) that a migraine is coming.
2. Muscle Tension Headaches:
   • The majority of headaches are caused by muscle tension.
   • The discomfort is usually diffuse and may be described as a "tight band" around the head. It may radiate down into the neck and shoulders. The discomfort can be aggravated by emotional stress.
   • This sounds like a painful headache that you are having, but there are pain medications you can take and other instructions I can give you to reduce the pain.
3. Pain Medicines:
   • For pain relief, take acetaminophen, ibuprofen or naproxen.
   • Acetaminophen (e.g., Tylenol):
     • Take 650 mg by mouth every 4-6 hours. Each Regular Strength Tylenol pill has 325 mg of acetaminophen.
     • Another choice is to take 1,000 mg every 8 hours. Each Extra Strength Tylenol pill has 500 mg of acetaminophen.
     • The most you should take each day is 3,000 mg.

   • Ibuprofen (e.g., Motrin, Advil):

     • Take 400 mg by mouth every 6 hours

     • Another choice is to take or 600 mg by mouth every 8 hours.

     • Use the lowest amount that makes your pain feel better.

   • Naproxen (e.g., Aleve)

     • Take 250-500 mg by mouth every 12 hours.

     • Use the lowest amount that makes your pain feel better.

   • Extra Notes

     • Acetaminophen is thought to be safer than ibuprofen or naproxen in people over 65 years old. Acetaminophen is in many OTC and prescription medicines. It might be in more than one medicine that you are taking. You need to be careful and not take an overdose. An overdose can hurt the liver.

     • Before taking any medicine, read all the instructions on the package.

4. Migraine Medication: If your doctor has prescribed specific medication for your migraine, take it as directed as soon as the migraine starts.
5. Rest: Lie down in a dark, quiet place and try to relax. Close your eyes and imagine your entire body relaxing.
6. Local Cold: Apply a cold wet washcloth or cold pack to the forehead for 20 minutes.
7. Stretching: Stretch and massage any tight neck muscles.
8. Call Your Doctor If:
   • Headache lasts longer than 24 hours
   • You become worse

And remember, contact your doctor if you develop any of the "Call Your Doctor" symptoms.