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Managing headaches

<p><span style="font-family: helvetica;">Headache are a common ailment usually experienced by everyone from time to time. Most people when experiencing a headache tend to self-prescribe over the counter medication, ignoring the fact that some types of headaches require medical attention.</span></p><p><span style="font-family: helvetica;">Headaches are categorized into either primary headaches or secondary headaches.
</span></p><p dir="ltr" style="padding: 0px; margin-top: 0px; margin-right: 0px; margin-bottom: 0px;"><span style="font-family: helvetica;">Primary headaches are caused by over activity of or problems with pain-sensitive structures in your head which can be triggered by fasting, alcohol, caffeine and caffeine withdrawal, stress or release from stress, too little or too much sleep, menstruation, fatigue, change in weather, head trauma, exposure to bright lights, loud noises, smoke, and strong scents and foods among others.

The most common primary headaches are: Cluster headaches, migraines and tension headaches.
</span></p><p dir="ltr" style="padding: 0px; margin-top: 0px; margin-right: 0px; margin-bottom: 0px;"><span style="font-family: helvetica;">These headaches have distinct features, such as an unusual duration or pain associated with a certain activity. Although generally considered primary, each could be a symptom of an underlying problem. Such underlying problems include:
<strong>Cough Associated Headaches</strong>

</span></p><p dir="ltr" style="padding: 0px; margin-top: 0px; margin-right: 0px; margin-bottom: 0px;"><span style="font-family: helvetica;">These are triggered by coughing and other types of straining such as from sneezing, blowing your nose, bending etc. Cough Associated coughs can be:
<strong>Primary cough headaches

</strong></span></p><ul><li><span style="font-family: helvetica;">Begin suddenly with and just after coughing or other types of straining</span></li><li><span style="font-family: helvetica;">Usually last a few seconds to a few minutes - some can last up to two hours
</span></li><li><span style="font-family: helvetica;">Cause sharp, stabbing or splitting pain</span></li><li><span style="font-family: helvetica;">Usually affect both sides of your head and may be worse in the back of your head</span></li><li><span style="font-family: helvetica;">May be followed by a dull, aching pain for hours</span></li></ul><p><strong style="font-family: helvetica;">Secondary cough headaches</strong></p><p><span style="font-family: helvetica;">Secondary cough headaches often have symptoms similar to those of primary cough headaches, though you may experience:</span></p><ul><li><span style="font-family: helvetica;">Longer lasting headaches</span></li><li><span style="font-family: helvetica;">Dizziness</span></li><li><span style="font-family: helvetica;">Unsteadiness
</span></li><li><span style="font-family: helvetica;">Fainting</span></li></ul><p><strong style="font-family: helvetica;">When to see a doctor </strong></p><p><span style="font-family: helvetica;">Consult your doctor if you experience sudden headaches after coughing especially if the headaches are frequent or severe or you have any other troubling signs or symptoms, such as imbalance or double vision.
</span></p><p><strong style="font-family: helvetica;">Exercise Induced Headaches</strong></p><p><span style="font-family: helvetica;">These occur during or after sustained, strenuous exercise. Doctors divide them into two:</span></p><ul><li><span style="font-family: helvetica;">Primary exercise headaches are usually harmless, aren&#39;t connected to any underlying problems and can often be prevented with medication and last between five minutes and 48 hours.</span></li><li><span style="font-family: helvetica;">Secondary exercise headaches are caused by an underlying, often serious problem within the brain such as bleeding or a tumor or outside the brain such as coronary artery disease .
</span></li></ul><p><span style="font-family: helvetica;">Secondary exercise headaches may require emergency medical attention.
</span></p><p><strong style="font-family: helvetica;">When to see a doctor</strong></p><p><span style="font-family: helvetica;">If you experience a headache during or after exercise that last at least a day and sometimes linger for several days or longer, consult your doctor. </span></p><p><span style="font-family: helvetica;">A secondary headache is a symptom of a disease that can activate the pain-sensitive nerves of the head. Any number of conditions varying greatly in severity may cause secondary headaches. Possible causes of secondary headaches include: Acute sinusitis, blood clot, within the brain separate from stroke, concussion, dehydration, dental problems, high blood pressure, medications to treat other disorders and stroke.
</span></p><p><span style="font-family: helvetica;">Types of secondary headache include:
</span></p><p><strong style="font-family: helvetica;">Spinal headaches</strong></p><p><span style="font-family: helvetica;">Caused by leakage of spinal fluid through a puncture hole in the tough membrane that surrounds the spinal cord. This leakage decreases the pressure exerted by the spinal fluid on the brain and spinal cord, which leads to a headache.</span></p><p><span style="font-family: helvetica;">Spinal headache symptoms include:</span></p><ul><li><span style="font-family: helvetica;">Dull, throbbing pain that varies in intensity from mild to incapacitating.</span></li><li><span style="font-family: helvetica;">Pain that typically gets worse when you sit up or stand and decreases or goes away when you lie down</span></li></ul><p><span style="font-family: helvetica;">Spinal headaches are often accompanied by: Dizziness, ringing in the ear, hearing loss, blurred or double vision, nausea and neck stiffness</span></p><p><strong style="font-family: helvetica;">When to see a doctor</strong></p><p><span style="font-family: helvetica;">Tell your doctor if you develop a headache after a spinal tap or spinal anesthesia - especially if the headache gets worse when you sit up or stand.
</span></p><p><strong style="font-family: helvetica;">Thunderclap headaches</strong></p><p><span style="font-family: helvetica;">This is uncommon, but they can warn of potentially life-threatening conditions usually having to do with bleeding in and around the brain. There is no obvious cause for some thunderclap headaches. In other cases, a variety of potentially life-threatening conditions might be responsible, including: bleeding between the brain and membranes covering the brain, rupture of a blood vessel in the brain, a tear in the lining of an artery that supplies blood to the brain, death of tissue or bleeding in the pituitary gland and blood clot in the brain.</span></p><p><span style="font-family: helvetica;">Symptoms include pain that:</span></p><ul><li><span style="font-family: helvetica;">Strikes suddenly and severely</span></li><li><span style="font-family: helvetica;">Peaks within 60 seconds</span></li><li><span style="font-family: helvetica;">Can be accompanied by nausea or vomiting</span></li><li><span style="font-family: helvetica;">Altered mental state</span></li><li><span style="font-family: helvetica;">Fever</span></li><li><span style="font-family: helvetica;">Seizures
</span></li></ul><p><strong style="font-family: helvetica;">When to see a doctor</strong></p><p><span style="font-family: helvetica;">Seek immediate medical attention for any headache that comes on suddenly and severely.</span></p><p><strong style="font-family: helvetica;">Conclusion</strong></p><p><span style="font-family: helvetica;">Generally, headaches are a common cause of short-term pain. Headaches are often underdiagnosed and or undertreated. Some patients can benefit from early recognition and elimination of factors that trigger their headaches. Patients and their healthcare providers may need to experiment to find optimal medications and dosages for managing headaches associated pain. </span></p><p><span style="font-family: helvetica;"><strong><em>By Dr Margarita Mwai, Consultant Family Physician at Aga Khan University Hospital</em></strong>

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