Headaches: It doesn't hurt to know
A headache is a fairly common ailment, but when does it warrant more serious medical attention than a painkiller?
"There is a need to get the right diagnosis to dismiss the more sinister secondary headaches and to distinguish whether it's a chronic headache, a tension headache or a migraine. One reason is that each involves different medications," says Dr Edward Wong, a specialist in neurology at Pacificare Medical Centre in Tsim Sha Tsui.
A tension headache is the most common, according to Dr N.V. Ramani, consultant neurologist at Raffles Neuroscience Centre in Singapore. "This headache lasts from some minutes to a few hours, typically affects both sides of the head, in the front and/or sides, often like a tight band. It usually occurs towards the end of the day, without nausea or visual disturbances."
The second most common headache is migraine, says Ramani. This lasts a few hours, or even days, and usually affects only one side of the head. It can be severe, and is usually associated with nausea and vomiting, and there is often increased sensitivity to light (photophobia) or sound (phonophobia). "There may be a warning where flashing lights or zigzag lines are seen just before the headache starts," he says.
Another frequent complaint is a cluster headache. These can occur daily or nightly as one-sided front headaches that are frequent, but short-lived, says Ramani. This headache typically disappears after a few days. It can recur up to a year later and may be associated with tears and a reddening of the eyes.
Ramani says these headaches are benign, or non-dangerous, headaches. Secondary headaches, however, are a symptom of some other more sinister health issue. These include conditions such as meningitis, brain tumour, brain aneurysm, stroke or glaucoma.
"Warning signs of a more serious cause include: a headache that starts for the first time above the age of 40; wakes you up from sleep, or is noticed on awakening; worsens after coughing, sneezing or straining; is associated with weakness or numbness or visual loss; occurs after a head injury; or does not respond to usual painkillers.
