HEADACHE

 

There is hardly a person who does not have a headache at any point in his life. 80% of people experience headaches that require medication from time to time. In only 10% of people with headache, the headache is severe enough to make the person lie down and distract from work and strength. Only 5-7% of the patients who apply to the physician due to headache have a structural disorder such as brain tumor, cerebrovascular disease (cerebral hemorrhage, cerebral vascular occlusion), inflammation in the brain or facial structures that cause headache. In other words, 90% of the patients who applied to the physician with the complaint of headache, did not find any disorder in the head or body that would cause the headache as a result of the examinations. We can only diagnose these headaches, which are not due to a structural disorder, based on the information we receive from the patient. Some of these headaches are summarized below.

 

Migraine

It occurs in 10% of men and 15-20% of women. It is a throbbing, severe headache that comes in seizures, lasts for hours, sometimes days, makes the patient lie down or distracts him from work, causes nausea and sometimes vomiting, causes discomfort from light and sound, and affects one half of the head. The specified headache characteristics do not have to be present in every patient. There are different types.

 

tension headache

It involves the entire head and mostly goes away with the contraction of the neck muscles. It is described by the patient as heaviness, burning, squeezing, pressure. Nausea and vomiting usually do not occur, do not increase with movement, often do not prevent the patient's activities. It can take as little as 5-10 minutes or for days. It recurs in the form of attacks or does not go away at all, it is continuous. 60% of people who have had frequent headaches for years have tension headaches.

 

cluster headache

It is characterized by a sudden onset and abrupt-ending severe headache, usually lasting around an hour, occurring once or several times a day, located on one side of the eye, forehead and temple. Headache is accompanied by nervous system symptoms such as eye bleeding, tearing, runny nose, swelling in the nose, sweating on the forehead and face, eyelid swelling, eyelid drooping, and narrowing of the pupil on that side. The pain comes several times a day or every other day and usually occurs at the same time, mostly at night. Such bouts of pain go away on their own after weeks or months. But once or twice a year or every few years, similar painful periods occur again. There are different types that are rare.

 

chronic daily headache

Patients have a constant headache that comes every day for years, lasts from morning to evening, and sometimes becomes so severe that the patient is hospitalized. Most of the patients initially have migraine and some have tension-type headache. These become more frequent and turn into a daily headache. Some patients develop chronic daily headache directly without migraine or tension-type headache. Most patients with chronic daily headaches take continuous pain medication. Although pain medications do not relieve the headache, the patient continues to take pain medication because headaches become more severe when pain medication is not taken. For this reason, the patient develops a kind of pain medication dependence.

 

Psychological pain and headaches

Pain occurs as one of the symptoms of various mental illnesses. In somatoform pain disorder, there is a complaint of pain that is not due to a specific physical cause, may be related to psychological factors, and significantly impairs the individual, social and occupational functions of the person. Pains of various mental causes do not conform to a specific anatomical structure, and may occur in multiple unrelated parts of the body. The location of the pain changes over time. If the pain in one area goes away with treatment, it reappears in another area. Pain medication will not help. Pain is usually continuous. Information about pain is very difficult; patients often give vague, contradictory or inconsistent answers. Although the pain occurs due to psychological reasons, patients often do not accept that they have emotional problems and conflicts, cannot make a connection between their mental state and pain, and exhibit exaggerated situations to prove the reality of their pain and that they are seriously ill. Treatment of mental pain is mainly medication and psychotherapy.

 

Various headaches not related to structural disorders

They are headaches that are mostly caused by physical effects and rarely require treatment. Headache due to external pressure of the head, headache due to cold head, headache due to eating and drinking cold food, headache that occurs during coughing, headache that occurs during exercise, headache that occurs during sexual activity... these can be counted. Headaches that are not due to structural disorders are not life threatening, but they seriously impair the quality of life and cause loss of work power. Recognizing and controlling the causes of headache by the patient, changing the way of life and reaction to external events, and using drugs that prevent pain (non-pain medicine) appropriately, sometimes almost complete and sometimes a great improvement can be achieved.