tips and approach to management of headache

1. Headache: An OPD approach
Dr. Vijay Pratap
Dept. of ophthalmology
M.L.B.M.C. Jhansi

2. What is headache
• Headache is the symptom of pain anywhere in the region of
the head or neck. It occurs in migraines (sharp or throbbing
pains), tension-type headaches, and cluster headaches.
• Frequent headaches can affect relationships and employment.
There is also an increased risk of depression in those with
severe headaches.

3. Types of headache
• Headaches are broadly classified as "primary" or "secondary“.
• Primary headaches are benign, recurrent headaches not caused
by underlying disease or structural problems. For
example, migraine is a type of primary headache. While
primary headaches may cause significant daily pain and
disability, they are not dangerous.
• Secondary headaches are caused by an underlying disease, like
an infection, head injury, vascular disorders, brain
bleed or tumors. Secondary headaches can be harmless or
dangerous. Certain "red flags" or warning signs indicate a
secondary headache may be dangerous

4. Primary headache
• Primary: headaches include, but are not limited to, tension- type and
migraine headaches and are not caused by other underlying medical
conditions. Over 90% of headaches are considered primary.
These includes.
Tension-type headaches,
Migraines
Cluster headaches
Trigeminal neuralgia
Primary cough headache
Primary exertional headache

5. Secondary headache
• Secondary: headaches result from other medical conditions, such as
infection or increased pressure in the skull due to tumor, disease, etc.
These account for fewer than 10% of all headaches.
• Causes are-
Meningitis,
Intracranial hemorrhage
Brain tumor
Temporal arteritis
Acute closed angle glaucoma
Post-ictal headaches

6. Tension-type Headaches
• Tension type headaches are the most common, affecting
upwards of 75% of all headache sufferers.
• As many as 90% of adults have had tension-type headache.
• These headaches are typically a steady ache rather than a
throbbing one, and affect both sides of the head

7. Migraine Headaches
• Less common than tension-type headaches, migraines
affect approximately 25 to 30 million people in the
United States.
• As many as 6% of all men and up to 18% of all women
(about 12% of the population as a whole) experience a
migraine headache at some time

8. Headache Triggers
• Many things can cause a headache, thus it is important for you to become aware of
the factors. Some examples of factors that can cause headache are outlined below:
• Emotional Factors: Stress (work, home, family), depression, anxiety, frustration,
let down, even positive excitement
• Dietary Factors: Alcohol, aspartame, cheese, chocolate, caffeine, monosodium
glutamate (MSG), processed meats containing nitrates
• Physical Factors: Getting too much or too little sleep, too much physical exertion,
injuries, skipping meals
• Environmental Factors: Glare from the sun or bright lights, changes in the
weather, strong odors, smog
• Hormonal Events: Menstruation, oral contraceptives, hormone replacement
therapies, menopause .
• Visual factor: During close work, reading

10. HEADACHE: Treatment Suggestions
• Cognitive-behavioral stress-management: Focuses on
increasing your understanding of the role of cognitions
(thoughts) in stress responses, and relationships between
stress, coping, and headaches
• Medications therapy- As like anti-depressant, analgesic,
anti-psychotic.
• Combination of behavioral and medication therapies

11. Headache Diary
DATE Time SEVERITY
1 = mild
2 =moderate
3 = severe
TRIGGER/S RELIEF
MEASURE/S
DURATION
Name- Age -
Sex- Occupation

12. Headache Diary-New initiation
• Why Use a Headache Diary ?
• Triggers: you may become more aware of your specific triggers
as you monitor your headaches. Keeping a headache diary will
help you determine whether factors such as food, change in
weather, and/or mood have any relationship to your headache
pattern.
• Track progress: diaries are also an excellent way to track your
progress in treatment.