What Could Headaches Be A Sign Of?

When headaches are caused by an underlying medical condition, they are called secondary headaches. Headaches could be a sign of stroke and others.

Pain in the head with the pain being above the eyes or the ears, behind the head (occipital), or in the back of the upper neck. Headache, like chest pain or backache, has many causes. 

There are different types of headaches.  The most common types of headaches are:

• Tension headaches (the most common form of headache) cause pressure or tightness on both sides of the head
• Migraine headaches often affect one side of the head and feel like pounding or throbbing pain
• Sinus headaches feature pain and pressure in the sinus area
• Other types of headaches that occur less frequently include
  • Cluster headaches, which are short but painful headaches that can occur for weeks or months at a time
  • Chronic daily headaches
  • Medication overuse headaches
  • Exercise-induced headaches

Tension headaches can be caused by:

• Stress
• Lack of sleep/fatigue
• Withdrawal from caffeine
• Hunger
• Suddenly stopping medications that contain caffeine
• Weather changes
• Certain foods and drinks, such as chocolate, processed foods with monosodium glutamate (msg), and alcohol

Migraine headaches may be triggered by many of the same things that can trigger tension headaches. Additionally, migraines may be triggered by: 

• Exposure to smoke
• Bright lights
• Certain smells
• Changes in estrogen levels for women
• Certain prescription medications, such as nitroglycerin and estrogen

When headaches are caused by an underlying medical condition, they are called secondary headaches. Headaches could be a sign of:

• Stroke 
• TIA (transient ischemic attack) 
• Carotid artery disease
• High blood pressure
• Infection
  • Meningitis
  • Encephalitis
  • AIDS
  • Pneumonia 
  • COVID-19
• Trauma to the head or neck (concussion, whiplash)
• Brain aneurysm
  • Often described as “the worst headache of your life” 
  • A medical emergency: get to a hospital’s emergency department immediately
• Seizures 
• Excessive cerebral spinal fluid pressure
• Dehydration 
• Kidney failure 
• Thyroid disorders 
• Allergies
• Sleep disorders such as sleep apnea
• A tumor (rare)

A doctor will take a history and perform a physical exam. Tests used to diagnose the type or cause of the headache include: 

• Computerized tomography (CT) scan
• Magnetic resonance imaging (MRI) scan
• Lumbar puncture for cerebrospinal fluid (CSF) analysis

Treatment for tension and migraine headaches includes: 

• Pain relievers
  • Aspirin 
  • Nonsteroidal anti-inflammatory drugs (NSAIDs)
    • Ibuprofen (Advil, Motrin)
    • Naproxen (Aleve)
    • Ketoprofen (Orudis)
  • Acetaminophen (Tylenol)
  • Analgesics containing caffeine often work best
• Other medications
  • Triptans
  • Trigger point injections
• Non-medical treatments
  • Heat
  • Ice
  • Massage
  • Rest
  • Biofeedback

In addition to the above, migraine headaches may also be treated with:

• Antiemetics
  • Chlorpromazine, prochlorperazine, droperidol, and diphenhydramine
• Selective serotonin 1F receptor agonist
  • Lasmiditan (Reyvow)
• Calcitonin-gene related peptide (CGRP) antagonists
  • Rimegepant (Nurtec)
  • Ubrogepant (Ubrelvy)
• Ergotamine preparations
  • Ergotamine (Ergomar)
  • Dihydroergotamine (D.H.E. 45, Migranal)
• Neuromodulation
  • Transcutaneous supraorbital nerve stimulation 
  • Remote electrical neuromodulation 
  • Transcranial magnetic stimulation (TMS) 
  • Noninvasive vagus nerve stimulation (nVNS) 
• Peripheral nerve blocks
  • Occipital nerve blocks 
  • Sphenopalatine ganglion blocks 

Some headaches may be prevented by avoiding headache triggers, such as:

• Stress
• Skipping meals 
• Too much or too little caffeine
• Sleeping too much or too little
• Drinking alcohol
• Certain drinks or foods

Relaxation techniques and stress management may also help prevent some headaches.