We all have headaches from time to time. But how do we know when a headache is more than just a headache – what are the symptoms?
Headaches are one of the most frequently cited medical complaints of modern society, affecting virtually every person during their lifetime. Each year more than five percent of the U.S. population will seek medical attention for a headache according to Kettering Health Network's Herbert B. Newton, MD, Neuro-Oncology and Neurology.
There are two main types of headaches - primary and secondary. Primary headaches are those not caused by other medical conditions and include migraine, tension and cluster headaches.
According to Tim Schoonover, D.O. Neurologist, Kettering Health Network, migraine headaches include intense pounding or pulsing headaches, which can be accompanied by an intolerance of sound or light, dizziness, nausea, and vomiting and can be caused by an increased interaction with triggers such as:
- An increased exposure to sunlight
- Changes in diet (eating more processed foods, snacking more, and drinking more carbonated, caffeinated, and alcoholic beverages)
- Changes in routine (sleeping less and traveling more)
- Dehydration
- Barometric pressure changes
Secondary headaches usually result from more serious medical conditions such as fever, an infection, over use of a medication, high blood pressure, a head injury, stroke, stress, tumors or a nerve disorder.
How do we decide that a headache should be investigated further to rule out a more dangerous variety or a secondary headache—such as a brain tumor?
"Most recurrent headaches are symptomatic of a chronic primary headache disorder, which occur without an underlying cause and include migraine, tension type, cluster, and miscellaneous headaches," Dr. Newton said. "Secondary headaches always have a direct underlying cause (e.g., subarachnoid hemorrhage, brain tumor, meningitis, carotid dissection), some of which can be life-threatening."
He suggested that patients with a new type of severe headache, headaches that are progressively getting worse and headaches that seem very persistent and do not respond to treatment, should all be investigated in more detail with a screening cranial CT scan or MRI scan to rule out a mass or brain tumor. In addition, any patient with questionable findings on the neurological examination, in the setting of persistent and escalating headaches, should undergo a CT or MRI.
Robert Hess, a math teacher at Weisenborn Junior High School in Huber Heights, was experiencing serious headaches causing him severe dizziness, speech impairment, and vomiting on occasion. After seeing a local doctor, he was sent to Dr. Newton's team for further observation and later CAT scans revealed that he had stage 3 brain cancer.
"I had extreme headaches and friends told me that they were even affecting my speech," Hess said. "Some of them were worse than others, but I underwent an MRI and CAT scans to determine a treatment. It's been nine years now that I am cancer-free. Now it is rare that I have any kind of headache. I still check in with Dr. Newton to make sure there are no other signs of cancer. He stays on top of things and talking to him is a comfort to me."
Headaches may be most severe in the morning. However, a morning headache is not specific only to brain tumors, since patients with migraines can also develop this pattern. Brain tumor-related headache pain is usually of moderate to severe intensity and will often last for hours at a time. The intensity of pain may be increased by coughing, sneezing, straining, or other maneuvers that increase chest pressure and head pressure, according to Dr. Newton.
See a doctor immediately or go to the Emergency Department if you have a sudden onset severe or atypical headache, headache following a head injury, or chronic headache that progresses in its severity, as these symptoms could indicate a more serious medical problem.
Have concerns about your headaches? Find a neuroscience physician at Kettering Health Network.