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.

Migraine with aura increases stroke risk   PhysOrg - October 28, 2009

Migraines increase stroke risk during pregnancy   PhysOrg - March 11, 2009

Severe Headaches Associated With Higher Temperatures, Lower Barometric Pressures   Science Daily - March 10, 2009

Clue to migraine headache cause BBC - December 26, 2007

Severe headaches may cause other pains, study suggests Guardian - November 20, 2007

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

Migraine brains 'are different' BBC - November 20, 2007

Magic, medicine eased ancient Egyptian headaches - Journal Cephalalgia - January 2002

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, 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.

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