Headache

Headache is one of the commonest problems that people encounter in their daily life. Mainly there are 2 types- primary and secondary headaches. Primary headaches include migraine, tension-type headache, and cluster headache. Secondary headaches are due to some causes like raised intracranial pressure due to various causes (at times no cause found called as Idiopathic intracranial hypertension(IIH)), cortical venous thrombosis, subarachnoid hemorrhage (SAH), neurological infections like TB, CNS vasculitis, and intracranial tumors.

The following types of headaches/symptoms (Red Flags) should prompt you to visit the neurologist at the earliest

1) New onset headache at old age
2) Headache with altered behavior and sensorium,
3) With the weakness of limbs and paralysis
4) With seizures
5) Worst headache of life
6) Headache that wakes a person from sleep
7) Associated with fever

Diagnosis-

If there are red flags or any doubt of secondary headache you may require the following tests on visiting the hospital

Imaging- CT/MRI Brain-Plain and if necessary contrast studies

CT/MR venography in some patients

At times if neurological infection or raised intracranial pressure is suspected you may require lumbar puncture with CSF analysis

Treatment-

The primary headache-Migraine/Tension-type headache have medications for symptom relief and medications for prevention of severe headache episodes For secondary headaches treatment of the cause will reduce headache.