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 analgesics.

Migraine

Migraine is a neurological syndrome characterized by altered bodily perceptions, headaches, and nausea. Physiologically, the migraine headache is a neurological condition more common to women than to men. Etymologically, the French word migraine derives from the Greek hemicrania (half skull) and the Old English megrim (severe headache).

The typical migraine headache is unilateral and pulsating, lasting from 4 to 72 hours; symptoms include nausea, vomiting, photophobia (increased sensitivity to bright light), and hyperacusis (increased sensitivity to noise); approximately one third of people who suffer migraine headache perceive an aura - visual, olfactory - announcing the headache.

Initial treatment is with analgesics for the head-ache, an anti-emetic for the nausea, and the avoidance of triggering conditions. The cause of migraine headache is unknown; the accepted theory is a disorder of the serotonergic control system, as PET scan has demonstrated the aura coincides with diffusion of cortical depression consequent to increased blood flow (up to 300% greater than baseline). There are migraine headache variants, some originate in the brainstem (featuring intercellular transport dysfunction of calcium and potassium ions) and some are genetically disposed.

Studies of twins indicate a 60 to 65 per cent genetic influence upon their developing propensity to migraine headache. Moreover, fluctuating hormone levels indicate a migraine relation: 75 percent of adult patients are women, although migraine affects approximately equal numbers of prepubescent boys and girls; propensity to migraine headache is known to disappear during pregnancy.

Tension headache

Tension headaches, which were renamed tension-type headaches by the International Headache Society in 1988, are the most common type of primary headaches. The pain can radiate from the neck, back, eyes, or other muscle groups in the body. Tension-type headaches account for nearly 90% of all headaches. Approximately 3% of the population suffers from chronic-tension type headache.

Cluster headache

Cluster headache, nicknamed "suicide headache", is a neurological disease that involves, as its most prominent feature, an immense degree of pain. "Cluster" refers to the tendency of these headaches to occur periodically, with active periods interrupted by spontaneous remissions. The cause of the disease is currently unknown. It affects approximately 0.1% of the population, and men are more commonly affected than women.

Top 10 Migraine Triggers

  Migraine cause 'identified' as genetic defect   BBC - September 27, 2010
Scientists have identified a genetic defect linked to migraine which could provide a target for new treatments. A flawed gene found in a family of migraine sufferers could help trigger the severe headaches, a study in Nature Medicine suggests.

Scientists discover how to 'switch off' pain of migraines   Telegraph.co.uk - September 27, 2010
Migraine sufferers could have their headaches switched off after researchers discovered a gene that acts like a pain thermostat in the brain. The "once in a generation" finding could allow scientists to create a new generation of drugs that can simply turn down up the threshold at which the body fells pain. The international study, including scientists at Oxford University, found that a gene called TRESK appears to be fundamental in causing migraines.

First genetic link to common migraine exposed   PhysOrg - August 30, 2010
The team found that patients with a particular DNA variant on Chromosome 8 between two genes - PGCP and MTDH/AEG-1 - have a significantly greater risk for developing migraine. Migraine affects approximately one in six women and one in twelve men, and has been estimated to be the most expensive brain disorder to society in the EU and US.

Migraine and depression may share genetic component   PhysOrg - January 14, 2010
New research shows that migraine and depression may share a strong genetic component. The research is published in the January 13, 2010, online issue of Neurology, the medical journal of the American Academy of Neurology.

Why Bright Light Worsens Migraine Headache Pain   Live Science - January 10, 2010
When a migraine hits, many sufferers hide out in a dark room, away from the painful light. Now scientists think they know why light makes migraines worse.

Migraine raises risk of most common form of stroke   PhysOrg - November 16, 2009
Pooling results from 21 studies, involving 622,381 men and women, researchers at Johns Hopkins have affirmed that migraine headaches are associated with more than twofold higher chances of the most common kind of stroke: those occurring when blood supply to the brain is suddenly cut off by the buildup of plaque or a blood clot.

Migraine with aura increases stroke risk   PhysOrg - October 28, 2009
Migraine with aura (temporary visual or sensory disturbances before or during a migraine headache) is associated with a twofold increased risk of stroke, finds a study published in the British Medical Journal today. Further risk factors for stroke among patients with migraine are being a woman, being young, being a smoker, and using oestrogen containing contraceptives.

Migraines increase stroke risk during pregnancy   PhysOrg - March 11, 2009
Women who suffer migraines are at an increased risk of stroke during pregnancy as well as other vascular conditions such as heart disease, high blood pressure and blood clots, concludes a study published on bmj.com today.

Severe Headaches Associated With Higher Temperatures, Lower Barometric Pressures   Science Daily - March 10, 2009
Although large numbers of headache sufferers, particularly individuals who struggle with migraines, attribute their pain to the weather, there has been little scientific evidence to back up their assertions. Now, a study of more than 7,000 patients, led by researchers at Beth Israel Deaconess Medical Center (BIDMC), provides some of the first large-scale data on how environmental conditions -- weather, as well as air pollution -- influence headache pain.

Clue to migraine headache cause BBC - December 26, 2007
Scientists may be a step closer to uncovering the cause of certain types of debilitating migraine headaches. A French team observed activation in the hypothalamus region of the brain as sufferers had a migraine attack. The hypothalamus has long been suspected as it regulates physiological responses to factors known to trigger headaches, such as hunger.

Severe headaches may cause other pains, study suggests Guardian - November 20, 2007
Migraines may do more than cause head-splitting pain, according to a study published today. People who experience severe headaches have differences in the part of the brain that deals with sensations, scientists have found. Neurologists who took brain images of 24 people who suffered frequent migraines and 12 who did not found that part of the brain called the somatosensory cortex - which processes information such as touch and pain - was 21% thicker in those who had a history of migraines.

Migraine shows up in the brain News in Science - November 20, 2007

Migraine brains 'are different' BBC - November 20, 2007
Scientists have discovered differences in the sensory areas of the brains of people who develop migraines. They found a part of the cortex is thicker than in people who are free from the debilitating headaches. What is not clear is whether the difference causes, or is the result of migraine attacks. The Neurology study, by Massachusetts General Hospital in Boston, suggests the changes may make patients hyper-sensitive to pain in general.

January 2002 - Reuters - NY

Can't beat that headache? Why not try an incantation to falcon-headed Horus, or a soothing poultice of "Ass's grease"? According to researchers, 3,500-year-old papyri show ancient Egyptians turning to both their gods and medicine to banish headache pain. "The border between magic and medicine is a modern invention; such distinctions did not exist for ancient healers," explain Dr. Axel Karenberg, a medical historian, and Dr. C. Leitz, an Egyptologist, both of the University of Cologne, Germany.

In a recent issue of the journal Cephalalgia, the researchers report on their study of papyrus scrolls dating from the early New Kingdom period of Egyptian history, about 1550 BC. Ancient Egyptian healers had only the barest understanding of anatomy or medicine. Indeed, while the head was considered the "leader" of the body, the brain itself was considered relatively unimportant--as evidenced by the fact that it was usually discarded during the mummification process.

Headache, that timeless bane of humanity, was usually ascribed to the activity of "demons," the German researchers write, although over time Egyptian physicians began to speculate that problems originating within the body, such as the incomplete digestion of food, might also be to blame.

Once beset with a headache, those living under the pharaohs turned to their gods for help. One incantation sought to evoke the gods' empathy, imagining that even immortals suffered headache pain. "'My head! My head!' said Horus," reads one papyrus. "'The side of my head!' said Thoth. 'Ache of my forehead,' said Horus. 'Upper part of my forehead!' said Thoth."

In this way, Karenberg and Leitz write, "the patient is identified with (the gods) Horus and Thoth," the latter being the god of magicians and wise men. The incantation continues with the sun god Ra ordering the patient to recover "up to your temples," while the patient threatens his "headache demons" with terrible punishments ("the trunk of your body will be cut off").

Still, the gods may have ignored the pleas of many patients, who also turned to medicine for relief. According to one ancient text, these included a poultice made of "skull of catfish," with the patient's head being "rubbed therewith for four days." Other prescriptions included stag's horn, lotus, frankincense and a concoction made from donkey called "Ass's grease." Even these remedies could be divinely inspired, however. On one 4,000-year-old scroll, a boastful druggist claims that his headache cure is prepared by the goddess Isis herself.