Headache,
a pain in the head resulting from the
distention of arteries in the region. It is
probably the commonest bodily complaint Less
than 15 percent of people report that they
never have headaches. For a new headache which
persists or recurs, and for a chronic headache
which changes in its nature, timing,
intensity, or quality, medical advice should
be sought. However, only one in two or three
hundred headache patients coming to the doctor
will have a headache from serious causes. It
is a mistaken though common belief that high
blood pressure is in itself a cause of
headache. Actually, the level of the blood
pressure has a little to do directly with the
presence or absence of headache, and many
people with high blood pressure never have
headaches. In very few cases are infections
and abnormalities of the eyes, teeth, nose, or
sinuses responsible for headache.
Headaches have two major origins: (1)
disturbances of the tissue inside of the head
– rare in occurrence; (2) disturbances on the
outside and adjacent to the skull – the usual
origin. In the first category are the
headaches associated with brain tumors, brain
abcesses, hemorrhages into the brain,
inflammation (meningitis), and other brain
injuries. Such headaches result from pulling
or pressing upon, or displacement or
inflammation of, the pain-sensitive blood
vessels, coverings, and nerves of the brain
(the brain itself is not pain sensitive). They
may also arise from excessive drinking of
alcohol (when one has a “hangover”),
inhalation of noxious gas, like a nitrite or
illuminating gas, or the onset of an infection
with fever. The alcohol, poisonous gas, or
infection, with fever causes the arteries of
the brain to distend, and this produces the
pain.
About a third of all headaches result from
sustained contraction of the skeletal muscles
of the head and neck. This type of headache
does not throb but is a steady ache, usually
not of great intensity, and it may go on for
days, weeks, or even years. It develops in
periods of tension, such as when a student
studies intensively for an examination, or
someone drives for long hours in heavy
traffic, or if a person is alerted and ready
for action, but the action does not take
place. It may occur along with a vascular
headache, and as secondary to pain from other
causes in the head, such as from sinus and
tooth infections, a cut or bruises on the
head, or eye-muscle imbalances.
The most common headache is vascular – the
so-called migraine or “sick” headache. This
type recurs periodically, often over many
years, and may begin as early as in the first
decade of childhood. Usually one sided at
onset, it may become generalized. It is often
accompanied by nausea and vomiting, sometimes
by visual disturbances and sometimes by
numbness and tingling of the arms and legs.
Migraine may occur in several members of the
same family. It results from the stretch of
arteries mainly on the outside of the head,
together with the accumulation in the tissues
of a substance which makes them tender and
easily hurt by pressure from throbbing
vessels.
Migraine headache may be of any intensity from
a slight dull ache to a throbbing pain of
prostrating severity. If it is moderate in
intensity, aspirin will eliminate the pain; if
severe, other means are necessary. Since
migraine results from painful distention of
the arteries of the head, a drug such as
ergotamine tartrate, capable of narrowing the
stretched arteries, can cause the headache to
diminish and disappear in less than an hour.
Unfortunately, this drug cannot be taken
frequently without harmful effect.
It has been found that migraine headaches
occur mostly in certain types of individuals,
the “perfectionists,” those with rigid
attitudes towards life in whom tension and
feelings of dissatisfaction and frustration
can build up. For many the mere knowledge that
the headaches come from inappropriate
adjustments to life and not from serious
damage within the skull is enough to effect an
improvement. Once aware of the nature of their
headaches and how they develop, some
individuals can help themselves to reduce or
eliminate their occurrence; others require
more extensive guidance.
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