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Headaches are a real pain

Headaches are a common source of daily pain and discomfort for millions.

How do I know if my headache is a health emergency or if I’m just suffering from too much stress?

Headaches are a common source of daily pain and discomfort for millions. The most common causes include fever due to infection, tension headaches due to stress and migraines caused by changes in blood flow in the brain. Other, more ominous, causes of headaches include bleeding due to ruptured blood vessels called aneurysms, strokes or meningitis.

Tension headaches are caused by spasm or inflammation of the muscles in the scalp and neck. These headaches are typically of gradual onset, limited duration and are more annoying than disabling. Tension headaches are usually not accompanied by other systemic symptoms such as fever, weakness, numbness, blurry vision or nausea and vomiting.

Headaches due to various illnesses may be caused by a sinus or dental infection, the fever of a cold or flu or, of greater concern, meningitis. Meningitis is a viral or bacterial infection of the lining and fluid surrounding the brain and spinal cord. The headache of meningitis is usually severe, gets rapidly worse and is accompanied by fever, neck stiffness and a toxic appearance. If you suspect your headache may be due to this potentially life-threatening infection, see your doctor immediately or go to the nearest emergency room.

A migraine headache is typically accompanied by other symptoms that may include nausea, a pounding sensation in the head or an aura (warning sensation) such as vision disturbances that may precede the headache. Migraines can be triggered by factors including food sensitivities, menstrual cycle hormonal changes, alcohol and lack of sleep.

The sudden onset of the worst headache of your life should be evaluated by a physician immediately. These symptoms typically signal a ruptured aneurysm, a potentially fatal leaking artery in the brain.

Most headaches are caused by benign conditions and can be treated with over-the-counter pain medication. The new onset of a headache that is different or worse than usual for you, or accompanied by symptoms that prevent you from going about your daily life, should be evaluated by a doctor sooner rather than later.

-- Mark Melrose, DO, is a board-certified emergency physician at Urgent Care Manhattan. E-mail him your questions at askdrmark@metro.us.

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