Headache, pain localized in and around the head, is almost always a harmless complaint. Brain tissue is numb. Therefore, the causes of headaches must be sought in the muscles and ligaments around the skull and neck, blood vessels, meninges and brain pressure.

 

Causes

Most headaches are tension headaches. Migraines and headaches caused by medication are numbers two and three. A patient may have multiple causes for their headaches. Psychosocial causes may play a role in headaches.

 

Headache syndromes

  • Tension headache: results from excessive sensitivity of the tendon attachments to the neck and skull. The patient feels this as if a band is tight around the head or as if the head or neck is being pushed from both sides. There is usually no vomiting or sensitivity to light or sound. Usually the headache persists for several hours.
  • Migraine: comes in attacks of rather severe throbbing headache on one side of the head, often with nausea, vomiting and with hypersensitivity to light and sound. The duration of the attack varies from half a day to three days. Often, symptoms such as flickering or black spots in front of the eyes or tingling precede the headache.
  • Medication-dependent headache: is chronic and often lasts more than three days a week. Causes include painkillers (including those for headaches), migraine drugs, coffee, alcohol (hangovers) and chocolate.
  • Cluster headache: is very intense sharp pain around the eye socket. The attacks last between fifteen minutes and three hours and occur in groups for several weeks. The patient cannot lie or sit still.
 

Headache as a sign of another problem

  • Inflammation of the nasal sinuses
  • Fever
  • Pressure increase within the skull. This can be caused by bleeding in the brain or in the meninges, hydrocephalus (water head), cerebral edema, for example after a head injury and so on.
  • Disease of the meninges; inflammation (meningitis), hemorrhage (arachnoidal hemorrhage).
 

Attention

Extra vigilance is needed if there are neurological symptoms, such as paralysis, transient or otherwise. Also, if a "new" headache occurs after the age of 50, migraine before the sixth year of life or for the first time after the age of 40, it is good to pay extra attention. Furthermore, if the headache, arising after an accident, is severe and getting worse or if it is severe and has occurred suddenly. Attention should also be paid to elderly people with pain in (one of) the temples(inflammation of a blood vessel) and with fever, especially if accompanied by a stiff neck. Furthermore, the doctor will be wary in pregnancy, small children, rapidly rising blood pressure and in vomiting unrelated to the headache.

Research

In tension, migraine and substance-dependent headaches, physical examination is not considered necessary. If a condition (infection or bleeding) of the meninges is suspected, the patient is urgently referred to the neurologist. The latter will perform an epidural while measuring the pressure. If a tumor is suspected, a CT scan or an MRI scan will be made.

 

Treatment

By keeping a headache diary, patients themselves can identify triggering causes (e.g., sleep problems, diet, arguments) and try to avoid them.

  • In the case of drug-dependent headaches, the suspected drug may just be discontinued completely immediately.
  • Short-term paracetamol and/or possibly an NSAID can be used as an analgesic.
  • With migraine, a distinction must be made between breaking up an attack (analgesic with vomiting agent; if that does not help a triptane, e.g. sumatriptan on the one hand and preventing an attack (beta-blocker or hormones (if menstrual-dependent) or sodium valproate)
  • Cluster headaches are treated with triptans. Oxygen is also used to break up an attack. This involves the use of a special non-rebreather mask. Alternative treatments include taking high doses of vitamin D or using small doses of hallucinogenic mushrooms to break up a series of attacks (cluster).
 

Treatment BeterKlinic

BeterKliniek is the clinic for Integrative Medicine that bridges regular and non-regular medicine.

An van Veen (physician) and Michael van Gils (therapist) look for the cause of a condition or disease. That is where the treatment starts otherwise, as people often say, it is 'carrying water to the sea'. We call this cause medicine. Sometimes it is also desirable to treat the symptoms (at the same time). We call this symptom medicine.

Chronic disorders often have their cause in epi- genetics. You can schedule a free informative telephone consultation (phone number 040-7117337 until 1 p.m.) at BeterKliniek to discuss your symptoms so that we can provide you with further advice.