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Headache (cont.)

Medical Author:
Benjamin Wedro, MD, FACEP, FAAEM

Dr. Ben Wedro practices emergency medicine at Gundersen Clinic, a regional trauma center in La Crosse, Wisconsin. His background includes undergraduate and medical studies at the University of Alberta, a Family Practice internship at Queen's University in Kingston, Ontario and residency training in Emergency Medicine at the University of Oklahoma Health Sciences Center.

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Medical Editor:
Jay W. Marks, MD
Jay W. Marks, MD
Jay W. Marks, MD

Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.

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Can cluster headaches be prevented?

Since cluster headache episodes may be spaced years apart, and since the first headache of a new cluster episode can't be predicted, daily medication may not be warranted.

Lifestyle changes may help minimize the risk of a cluster headache flare. Stopping smoking and minimizing alcohol may prevent future episodes of cluster headache.

What diseases cause secondary headaches?

Headache is a symptom associated with many illnesses. While head pain itself is the issue with primary headaches, secondary headaches are due to an underlying disease or injury that needs to be diagnosed and treated. Controlling the headache symptom will need to occur at the same time that diagnostic tests are being considered to diagnose the underlying disease. Some of the causes of secondary headache may be potentially life-threatening and deadly. Early diagnosis and treatment is essential if damage is to be limited.

The International Headache Society lists eight categories of secondary headache. A few examples in each category are noted (This is not a complete list.).

Head and neck trauma

  • Injuries to the head may cause bleeding in the spaces between the layers of tissue that surround the brain (subdural, epidural, and subarachnoid spaces) or within the brain tissue itself (intracerebral hemorrhage: intra=within + cerebral=brain, hemorrhage=bleeding).
  • Edema or swelling within the brain, not associated with bleeding, may cause pain and a change in mental function.
  • Concussions, where head injury occurs without bleeding. Headache is one of the hallmarks of post-concussion syndrome.
  • Whiplash and neck injury also cause head pain.

Blood vessel problems in the head and neck

  • Stroke or transient ischemic attack (TIA)
  • Arteriovenous malformations (AVM) may cause headache before they leak.
  • Cerebral aneurysm and subarachnoid hemorrhage. An aneurysm, or a weakened area in a blood vessel wall, can expand and leak a small amount of blood causing what is called a sentinel headache. This may be a warning sign of a future catastrophic bleed into the brain.
  • Carotid artery inflammation
  • Temporal arteritis (inflammation of the temporal artery)

Non-blood vessel problems of the brain

  • Brain tumors, either primary, originating in the brain, or metastatic from a cancer that began in another organ
  • Seizures
  • Idiopathic intracranial hypertension, historically called pseudotumor cerebri, where pressure within the spinal canal increases. The cause is unknown and while it can occur in all ages, it often affects young, obese females. Idiopathic intracranial hypertension can cause significant headache and if left untreated may, on occasion, lead to blindness.

Medications and drugs (including withdrawal from those drugs)

Infection

  • Meningitis
  • Encephalitis
  • HIV/AIDS
  • Systemic infections (for example, pneumonia or influenza)

Changes in the body's environment

Problems with the eyes, ears, nose throat, teeth, sinuses, and neck

Psychiatric disorders

Reviewed by Jay W. Marks, MD on 5/16/2013

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