As headache signals may be an indicator of life-threatening diseases, it is necessary to consult a doctor without loss of time.

Every Headache Is Not InnocentAlthough the headache that we experience for several reasons is sometimes innocent and looks natural to many of us, they are not all innocent. As headache signals may be an indicator of life-threatening diseases, it is necessary to consult a doctor without losing time.
Headaches arise from the vessels, muscles, joint of the jaw and scalp in the head and neck region. Brain tissue has no sensation of pain itself. The surrounding tissues are sensitive to pain.

Therefore, we, neurosurgeons, have sometimes the opportunity to perform some surgeries on the brain without putting under the patients general anesthesia. There is no one in the population who doesn’t suffer from headache at some point in his or her life.

Those pains may be short-term (acute attack) or constant (chronic). The majority of the pains is not serious.

HOW MANY TYPES are there?

Pains are usually categorized into 3 types. Mild, moderate and severe... Headaches are also related to age. It is generally more common in middle age group. This limit is likely to be severe up to 40-50 years old. This rate reduces in late years. There is also a familial tendency. In medical practice, we evaluate those headaches as acute, subacute and chronic. Moderate and severe headaches are two times more common in women than in men!

The units that acute headaches, that is, with sudden onset and severe headaches should consult are emergency services. Subacute and chronic pain are assessed under normal examination conditions. The persistence or severity of pain leads us, the physicians, to specific diagnostic methods.

When assessing the headaches, the most common headache is migraine or tension-type headaches. Migraine has the most negative impact on quality of life. If there is pain over a period of 15 days in a month, it means that the chronic headache is developed.

A headache due to a brain damage or some metabolic conditions is called a secondary headache.

Infections (such as sinusitis etc., brain abscesses, meningitis)

Brain tumors (tumors spread from the brain's own several different tumors or metastatic tumor spreading from other organs)


  • Every Headache Is Not InnocentBrain hemorrhages (With diverse variable causes)
  • Pains that we call temporal arteritis caused by some arteries (vessels) on both sides of the skull
  • Hypertension or the effects some medications used may cause headache.
  • Very severe pain (the statement of the patient is "a bomb exploded in my head") is usually caused by aneurysms or other forms of glomeruli or cavernosomes that we call, and requires emergency medical intervention. It is life-threatening.
  • Sometimes these acute headaches are the bleedings occur between the celebral cortex, which we refer to as subdural, and the brain due to a small accident that the patient ignores before. (It often occurs in elderly patients and may be missed by Alzheimer's or early dementia prediagnoses)
  • Another type of headache is tension-type headache. Tension-type headaches are both shorter and do not affect our daily life.

MIGRAINE is a disease

Migraine is not only a headache but also a disease. It is a throbbing headache, light, sound, odor sensitivity, stress, hormones (especially in women's menstrual cycles), changes of air (seasonal changes that we call soutwest in our country, and foehns in European countries) and some foods may induce the headcahe.

Here are the OTHER REASONS

  • Early diagnosis of the headache is very important. Other reasons of the pain can be listed as follows;
  • Bleedings
  • The clinical symptoms as if there is a tumor in your brain that we call Pseudotumor
  • Meningitis
  • Headaches due to occlusion of some of the veins in the brain which we call sinus thrombosis
  • Sinus diseases (sinusitis)
  • Some ear diseases
  • Diseases due to tooth diseases
  • Diseases caused by some cranial nerves
  • Shingles
  • Trigeminal neuralgia
  • Pain due to glossopharyngeal nerve (pain usually spreading from the palate, jaw and behind the tongue to the jaw)
  • Some pains associated with superficial nerves passing through the scalp (such as occipital neuralgia etc.)
  • Pathological conditions related to increased intracranial pressure (bleeding, tumor, abscess etc.)
  • Events that reduce intracranial pressure (for example, pathologies develop due to fluid leak related to a tear in the spinal cord cause headache).


If the headache begins suddenly and is very severe, accompanies fever or vomiting, you have never had such a severe pain in your life, and you are now experiencing this kind of pain, if any disorder in your nervous system is accompanied by this pain (e.g. seizure, paralysis, sensory loss, visual impairment, etc.) change in your consciousness (if there is a tendency to sleep), pls contact the nearest and well-equipped hospital you know.

WARNING about the drugs

No medication should be used without consulting a doctor except for simple painkillers for the headaches. Headaches due to serious diseases do not respond much to painkillers. In some pains, they may still lead to a delay in consulting a doctor, and thus a little delaying in the diagnosis and treatment by providing transient improvement or decrease in the severity of the pain. Another important risk is that, for example, some drugs with blood thinning effect that exacerbate the bleeding in cerebral hemorrhages. Therefore, people should consult a doctor as soon as possible instead of trying to find a solution for such headaches in their way.


Here are the signs that should be taken seriously in the headache...

1. Headaches that are very severe and with sudden onset: If the person is describing a headache for the first time in his life which is very severe and reaches its highest severity in about 1 minute, a subarachnoid hemorrhage is suspected. Subarachnoid hemorrhage is caused by the tear of aneurysms which can be described as balloon-like bulges in brain vessel walls due to a malformation. Headache is also described by some of the patients as "something was exploded in my head." In patient with no complaint, consciousness, drowsiness, nausea, vomiting, photosensitivity, epileptic (fit) seizures may be observed with sudden and severe headache. About one fourth of the patients may be lost within the first 24 hours. Therefore, the patient must be transferred to the hospital immediately.

2. Headache that is getting worse and becomes chronic: Although headache is frequently observed without an underlying serious disease, it should be taken seriously if the pain is increasing. Headache that is progressively getting worse in a young woman who is smoker and uses oral contraceptive pill may be a sign of a disease that requires quick onset of treatment such as cerebral sinus thrombosis which is the result of clotting in the brain vessels.

3. Headache caused by sneezing, straining, sexual activity or effort: Headache that occurs due to increased intracranial pressure with exercise, sneezing or straining may suggest a space occupying lesion. Brain tumors, aneurysms, as well as diseases such as pseudotumor cerebri, which is caused by increased pressure of the cerebrospinal fluid observed more frequently in young and middle-aged obese women may cause this type of headache.

4. Headache that occurs after head trauma: After severe head traumas such as traffic accidents, fractures may occur in the cranial bones, bleeding in the brain tissue or between the meninges. Less frequently, bleedings as leaking between the brain membranes may not appear at the beginning, but may occur with signs such as headache and malaise days, even months after the trauma.

5. Headache accompanied by neurological symptoms such as numbness in the arms and legs, weakness, visual impairment, speech disorder: Together with headache, these neurological manifestations indicate a problem in the brain tissue. In addition to the above diseases, for example, headache may be observed in 10% of stroke patients before the stroke.

6. Headaches that are persistent despite treatment: Many diseases such as space occupying lesions in the brain, tumors, increased intracranial pressure, structural changes in the brain, e.g. central nervous system infections, and causing irritation may be observed as resistant headaches.

7. Headache that is always located in the same area: It may occur due to the lesion occupying that area.

8. Accompanying high fever, drowsiness, confusion or body rashes: Meningitis is the inflammation of the membranes surrounding the brain, and encephalitis is the inflammation of the brain tissue due to infectious agents. A headache that is progressively getting worse is observed in almost all of these patients. High fever, fatigue, drowsiness together with headache should suggest that the brain is definitely affected by the infection. Infections of the central nervous system also comprise the diseases that can be fatal or cause disability.

9. Newly-onset headaches in advanced age: Temporal arteritis is a serious disease affecting individuals over the age of 50. Moderate or severe, worsening headache may accompany symptoms such as weakness, joint pains, visual impairment and fatigue when chewing. Delayed treatment may cause permanent vision loss and brain damage. Again the headache that occurs in older ages should remind the cerebrovascular diseases and brain tumors.

SÖZCÜ Newspaper / February 08th, 2018

Date 3/1/2018 editö
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