HEADACHE

In medicine a headache or cephalalgia is a symptom of a number of different conditions of the head and sometimes neck. Some of the causes are benign while others are medical emergencies. It ranks among the most common pain complaints ]There are a number of different classification systems for headaches. The most well-recognized is that of the International Headache Society.

Treatment of a headache depends on the underlying etiology or cause, but commonly involves analgesicsHeadache associated with specific symptoms may warrant urgent medical attention, particularly sudden, severe headache or sudden headache associated with a stiff neck; headaches associated with fever, convulsions or accompanied by confusion or loss of consciousness; headaches following a blow to the head, or associated with pain in the eye or ear; persistent headache in a person with no previous history of headaches; and recurring headache in children

The brain in itself is not sensitive to pain, because it lacks nociceptors. Several areas of the head neck however can sense pain. These include: extracranial arteries, large veins, cranial and spinal nerves, head and neck muscles, the meninges, raised intracranial pressure, disturbance of the intracerebral serotonergic levels. When the headache does not clearly fit into one of the recognized primary headache syndromes or when atypical symptoms or signs are present then further investigations are justified. Neuroimaging ( noncontrast head CT ) is recommended if there are new neurological problems such as decreased level of consciousness, one sided weakness, pupil size difference, etc or if the pain is of sudden onset and severe, or if the person is known HIV positive. People over the age of 50 years may also warrant a CT scan.

In recurrent unexplained headaches, health care professionals may recommend keeping a "headache diary" with entries on type of headache, associated symptoms, precipitating and aggravating factors. This may reveal specific patterns, such as an association with medication, menstruation or absenteeism or with certain foods. It was reported in March 2007 by two separate teams of researchers that stimulating the brain with implanted electrodes appears to help ease the pain of cluster headaches.