Headache is one of the most frequently encountered problem

Headache

Headache is one of the most frequently encountered problem at a clinic. Even questions at lybrate are mostly studded with this symptom.
More often than not, headaches are self limiting and without a serious medical problem. But any chronic headache needs proper evaluation for definitive therapy.
Grossly, headaches can be divided into primary (no definite structural lesion in brain) or secondary (associated with changes).
Any headache, if associated with vomiting without nausea, visual disturbance or nerve deficit (new onset squint, double vision, loss of sensation anywhere, facial deviation amongst many) may indicate secondary headache, but exceptions are there. These require immediate attention to rule out life threatening disease.
Commonest primary headache is tension type headache all of us have felt at certain times. Often it is like a band pressing around forehead. Common analgesics manage them well but for recurrent problem, we might prescribe prophylactic drug.
Migraine is something very common presenting as pain in one half of head with vomiting, nausea, visual or auditory aura. They require immediate analgesic like acetaminophen and prophylaxis with propranolol or amitriptyline.
Cluster headache, as the name suggests, comes in cluster for few days and more common in male. Oxygen has been proven as effective treatment.
Trigeminal neuralgia is more sharp, lanceolating pain, but responds satisfactorily to carbamazepine.
Sinusitis, in frontal bone presents as headache more around 10am in the morning that requires therapy with antihistamines and antibiotics occasionally.
Therefore' headache' carries little value unless it is described in detail to ensure proper therapy.