Management Team

Headache

Overview

Headache is a prevalent condition, presented with pain or discomfort in the head and neck region. Most chronic headaches are vascular in nature and typically not life-threatening.

  • Acute severe headache which has never happened in past (acute thunderclap headache)
  • Change in character/ severity/ location of headache
  • Headache associated with focal neurological signs like weakness/ visual disturbances
  • Headache along with loss of consciousness/ seizures
  • New onset headache in elderly
  • Headache worsening while leaning forward or straining

  • Tension type headache
  • Sinus headache
  • Migraine
  • Rebound headache (due to overuse of pain medication)
  • Cluster headache
  • Idiopathic intracranial hypertension
  • Mixed headache as in combination of tension type headache and migraine

  • Mass lesion in brain like tumour or granuloma
  • Head injury
  • Intracranial or subdural haemorrhage
  • Meningitis/ encephalitis/ other CNS infections
  • Raised intracranial pressure due to brain swelling
  • Vasculitis/ other inflammatory disorders of CNS

  • Sex
  • Body mass index (BMI)
  • Smoking
  • Family history
  • Climate
  • Excessive caffeine consumption
  • Age
  • Overuse of medication
  • Psychiatric comorbidities (e.g., anxiety, insomnia, and depression)
  • Occipital spur
  • Chronic dehydration
  • Temporomandibular disorders

Neurologist

  • History and clinical examination
  • Fundus examination to check for signs of raised intracranial pressure
  • MRI/ CT head whenever required

  • Supportive- rest, pain abortive medications like paracetamol, naproxen depending on cause of headache
  • Prophylactic medication- on a regular basis
  • Specific treatment- CSF drainage/ removal of lesion depending on aetiology
  • Lifestyle changes and avoidance of precipitating factors
  • Botulinum injection in specific cases
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