Over 90% of the general population will experience a headache at some point in their lives, making it the most common condition neurologist encounter. Most recurrent headaches are symptomatic of a chronic, primary headache disorder, i.e. migraines, cluster headaches, or exertional headaches. However, headaches can also be from organic (physical) causes which include: tumors, infections, cranial arthritis, major neuralgias, vessel dissections, or hematomas. Headaches may also arise from extracranial locations such as from temprormandibular joint (TMJ) disorders and cervical osteoarthritis and from trauma.
Patients who have persistent headaches need to be evaluated systematically for underlining conditions which can cause headaches. All patients must undergo careful and thorough examinations to rule out treatable causes. Diagnosis is based on: history, physical examinations, laboratory results, radiological examinations and other ancillary tests. Once organic causes of headaches are ruled out, a diagnosis of other primary headache syndromes can be made.
Treatment is tailored to the specific subtype of headache diagnosed. There are a wide variety of treatment options available since our knowledge of migraine pathophysiology has exploded over the past two decades. When properly tailored and applied, providing treatments for migraineurs can be very rewarding and challenging.
Severe onset of headaches (thunderclap headaches) requires urgent, immediate care in the emergency room to evaluate for subarachnoid hemorrhage (stroke).
Do not ignore your headaches. Always consult your doctor for your headaches or, if necessary, go to your nearest emergency room if you experience persistent, severe headaches.
This is a brief overview of headaches and is not meant to be a substitute for medical advice.