Like other types of pain, headaches can serve as warning
signals of more serious disorders. This is particularly true for
headaches caused by traction or inflammation.
Traction headaches can occur if the pain-sensitive parts of the
head are pulled, stretched, or displaced, as, for example, when eye
muscles are tensed to compensate for eyestrain. Headaches caused by
inflammation include those related to meningitis as well as those
resulting from diseases of the sinuses, spine, neck, ears, and
teeth. Ear and tooth infections and glaucoma can cause headaches.
In oral and dental disorders, headache is experienced as pain in
the entire head, including the face.
Traction and inflammatory headaches are treated by curing the
underlying problem. This may involve surgery, antibiotics or other
Characteristics of the various types of traction and
inflammatory headaches vary by disorder:
Brain tumors are diagnosed in
about 11,000 people every year. As they grow, these tumors
sometimes cause headache by pushing on the outer layer of nerve
tissue that covers the brain or by pressing against pain-sensitive
blood vessel walls. Headache resulting from a brain tumor may be
periodic or continuous. Typically, it feels like a strong pressure
is being applied to the head. The pain is relieved when the tumor
is destroyed by surgery, radiation, or chemotherapy.
Headache may accompany several
conditions that can lead to stroke, including hypertension or high
blood pressure, arteriosclerosis, and heart disease. Headaches are
also associated with completed stroke, when brain cells die from
lack of sufficient oxygen.
Many stroke-related headaches can be prevented by careful
management of the patient's condition through diet, exercise, and
Mild to moderate headaches are associated with transient
ischemic attacks (TIA's), sometimes called "mini-strokes,"which
result from a temporary lack of blood supply to the brain. The head
pain occurs near the clot or lesion that blocks blood flow. The
similarity between migraine and symptoms of TIA can cause problems
in diagnosis. The rare person under age 40 who suffers a TIA may be
misdiagnosed as having migraine; similarly, TIA-prone older
patients who suffer migraine may be misdiagnosed as having
About one-fourth of the people who
undergo a lumbar puncture or spinal tap develop a headache. Many
scientists believe these headaches result from leakage of the
cerebrospinal fluid that flows through pain-sensitive membranes
around the brain and down to the spinal cord. The fluid, they
suggest, drains through the tiny hole created by the spinal tap
needle, causing the membranes to rub painfully against the bony
skull. Since headache pain occurs only when the patient stands up,
the "cure" is to remain lying down until the headache runs its
course--anywhere from a few hours to several days.
Headaches may develop after a
blow to the head, either immediately or months later. There is
little relationship between the severity of the trauma and the
intensity of headache pain. One cause of trauma headache is scar
formation in the scalp. Another is ruptured blood vessels which
result in an accumulation of blood called a hematoma. This mass of
blood can displace brain tissue and cause headaches as well as
weakness, confusion, memory loss, and seizures. Hematomas can be
drained to produce rapid relief of symptoms.
Arteritis and meningitis.
inflammation of certain arteries in the head, primarily affects
people over age 50. Symptoms include throbbing headache, fever, and
loss of appetite. Some patients experience blurring or loss of
vision. Prompt treatment with corticosteroid drugs helps to relieve
Headaches are also caused by infections of meninges, the brain's
outer covering, and phlebitis, a vein inflammation.
or tic douloureux, results from a disorder of the trigeminal nerve.
This nerve supplies the face, teeth, mouth, and nasal cavity with
feeling and also enables the mouth muscles to chew. Symptoms are
headache and intense facial pain that comes in short, excruciating
jabs set off by the slightest touch to or movement of trigger
points in the face or mouth. People with trigeminal neuralgia often
fear brushing their teeth or chewing on the side of the mouth that
is affected. Many trigeminal neuralgia patients are controlled with
drugs, including carbamazepine. Patients who do not respond to
drugs may be helped by surgery on the trigeminal nerve.
. In a condition called acute
sinusitis, a viral or bacterial infection of the upper respiratory
tract spreads to the membrane which lines the sinus cavities. When
one or all four of these cavities are filled with bacterial or
viral fluid, they become inflamed, causing pain and sometimes
headache. Treatment of acute sinusitis includes antibiotics,
analgesics, and decongestants. Chronic sinusitis may be caused by
an allergy to such irritants as dust, ragweed, animal hair, and
smoke. Research scientists disagree about whether chronic sinusitis