Ep. 26: Simple to Life-Threatening Headache Causes You Need to Know
Today’s episode of the Dr. Momma Says podcast intends to share an overview of the wide range of headache causes because a headache is not just a headache. Most of us get them from time to time, but everytime it happens, there is a reason. Your body is trying to tell you something, and you should listen. Although most headaches are never evaluated or treated, it is important for you to understand many of the horrible headache causes. Some of them can be life-threatening, so be sure to speak to your physician if you have a concern.
How Common are headaches?
The short answer: VERY!
Lots of information online but let me share a few general statistics:
- About 2/3 of people will have headaches at some point. (wow. I thought it was 100%)
- 15% of headaches are caused by migraines
- Over 50% are due to tension headaches.
- 4-5% of Emergency room visits are due to headaches.
- Headaches are one of the most common reasons people use over the counter pain medications like Tylenol and Motrin. These meds are usually safe but both of them can lead to complicated medical problems.
- Tylenol can damage the liver, aspirin increases your risk of bleeding because it slows down the ability of blood to clot and Motrin not only can be irritating to stomach causing gastritis or ulcers but may cause or worsen kidney disease.
So it is best to determine the cause of the recurrent headaches and find a specific treatment plan.
Medical History is crucial to determine horrible headache causes
Many times, physicians determine what is causing the headache based on your medical history. I have continually beat the drum that it is extremely important for you to know your own and your family members’ medical history.
When discussing your symptoms with your physician, it is a good idea to write down symptoms before the visit. You want to avoid being THAT patient who is unprepared! Some of the questions I frequently ask (as an ENT physician) include:
- How long have they been occurring?
- What time of day do they occur?
- How long do they last?
- What makes them better?
- What makes them worse?
- Are there any symptoms that occur before, during and after a headache?
- Any recent illnesses?
- Bonus: Use ONE finger and point to the area that tends to have the worst pain!
Two Basic Categories of Headache Causes
Headaches are broken down into two types: primary or secondary
A primary headache is a headache that is due to the headache condition itself and not due to another cause.
- Meaning, there is no nasal congestion, infection or other problem.
- Just a headache…primary
- If a headache is associated with another problem, it is a secondary headache.
Wouldn’t it be nice if all primary headaches were easy to spot? Well, there can be associated symptoms that may make things confusing, like nausea and vomiting or vision changes with migraines.
But honestly, the key to differentiating a secondary headache from a primary headache is based on a really good history.
Primary Headache Causes
A primary headache is caused by overactivity of or problems with pain-sensitive structures in your head. A primary headache isn’t a symptom of an underlying problem or disease.
Chemical activity in the brain, the nerves or blood vessels in the skull, and the muscles in the head and neck area all can contribute and play a role in causing primary headaches.
Some people may also carry genes that make them more likely to develop such headaches.
Most types of primary headaches fall under the following three categories. Be sure to listen in to the podcast for a more detailed description and examples.
- Tension-Type Headache: the most common type of primary headache.
- Migraines: a disorder of with recurrent headache attacks.
- Cluster Headache: also known as a histamine headache, are pretty rare.
Secondary Headache Causes
Now let me run through a list of common secondary headache causes.
Ask my girls if this is not one of my favorite questions when they had ANY issue, not just headaches: How much water did you drink? Keeping your body hydrated is important for many reasons, and when you get dehydrated, lots of symptoms occur.
Let’s be honest, there are many days we could all drink a bit more water. If you start feeling bad, take a minute to reflect on your hydration status.
Many dieters can tell you that sometimes when your body thinks it is hungry, it is actually thirsty. So this throws us back to the dehydration cause. But hunger and starvation can also lead to headaches.
Stress is a classic trigger of headaches
Many of my patients have already been to an eye doctor for headaches and had new glasses prescribed. But when the headaches continued, they realized that something else was the cause. Glaucoma, increased pressure in the eyeballs, is also a cause of headaches.
Dental and Jaw problems
TMJ is the common term we say for an area called TemporoMandibular Joint. It is the area you feel move when you place your hand in front of your ear and then open and close your mouth. This joint can have a variety of problems that can lead to head pain. Other dental and jaw problems may lead to poor alignment and head pain.
Excess head compression
External compression headaches can occur when something worn on your head puts continuous pressure on your forehead or scalp. They often occur in people required to wear certain headwear, such as helmets or goggles, for their work or sports activities.
Ice Cream Headaches
Ice cream headaches (also known as brain freeze!) are brief, stabbing headaches that can happen when you eat, drink or inhale something cold. This type of a headache is caused either by exposing your head to sudden, extreme cold or by having something cold move across the roof of your mouth and the back of your throat, such as when you eat ice cream quickly or gulp a cold drink.
It is officially known as cold stimulus headaches but that is not nearly as great of a name as brain freeze!
This category is my bread and butter. I see this daily. Not uncommon for me to see kids with chronic headaches who have already been seen by the neurologist looking for a more ugly reason for the headaches.
I have already posted blogs and podcasts about allergies, mouth breathing, and nasal congestion. No particular reason to elaborate on these more now but this category includes, of course, that common cold and viral illness as well as allergies and turbinate enlargement (remember the post I wrote about all the parts of the nose?)
This is an extremely common ENT reason for headaches, but I don’t include sinus problems in the same bucket as nasal congestion and stuffy nose. Sinus problems take things to the next level. There can be acute/ new sinus infections or chronic sinus infections. There may also be nasal polyps that form or a variety of rare sinus tumors and masses.
For everything you need to know about sinus problems, be sure to check out the previous episodes that discuss the sinus cavities in general, how to diagnose sinus infections/problems, sinus problem treatments and of course, some of the ugly sinusitis complications.
You know what? I just cannot believe I have not dedicated a post to the adenoid since I am evaluating them many times every day. I need to get on that!
The adenoid is a lymph node behind the nose. I call it a nose tonsil because many people have never heard of it.
No one ever asks me what a tonsil is, but I am always asked what an adenoid it. Same thing, different location. If it gets inflamed and large, it blocks the nose and can be a cause of a headache.
Reviewing my post about all the fabulous functions of the nose, you will learn the anatomy of the nose and understand the septum divides the nose in half. There are two equal passages or supposed to be. If the septum is crooked, due to birth trauma, other injury or just formed that way, the air is not equally distributed. The narrow side may allow the septum to touch the other side of the nose and debilitating headaches can happen.
In my patients, strep throat often presents with a headache, so it is important to check the throat in young kids with a severe headache. Other irritations can lead to referred head pain, like post nasal drip and viral pharyngitis. Gastric acid reflux may be a headache cause when repeatedly burping up stomach acid into the throat.
When checking for headache causes, the problems due to issues in the brain are the ones that cannot be missed. These are the potentially life-threatening ones. And the symptoms can overlap with other headache causes.
The most common brain problems associated with a headache include: Brain tumors, bleeding into the fluid around the brain or into the brain tissue itself, infection of the fluid around the brain (meningitis) or infection of the brain (encephalitis— especially with some of the vaccine-preventable viral illnesses like measles and the flu. (#vaccineswork)
Additional brain causes of a headache include a true stroke and head trauma that can not only lead to bleeding in several areas but can also lead to headaches from concussions.
High Blood Pressure
Some people can experience a headache when their blood pressure is too high, which has caused many doctors and researchers to tie hypertension to the headaches. However, high blood pressure has not been definitely linked to headaches. This is one of the reasons this disease is called the silent killer. Nevertheless, severe headaches may be a sign of dangerously high blood pressure.
Substance Overuse or withdrawal
This last category includes the well-known hangover from excessive alcohol and caffeine withdrawal when coffee addicts decide to quit cold turkey. Not a good plan.
In ENT we see this in patients who become addicted to nose sprays like Afrin. When it is stopped there is a rebound swelling and severe headaches can occur.
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