Chronic Headaches

Everyone knows what a headache is. Some are mild and some can be severe and life threatening. The physician needs to evaluate each headache quickly and thoroughly and decide accurately which treatment is needed. Tension headaches, usually related to stress, are commonly located over the back of the head and the neck. Sometimes headaches are the result of lack of good sleep. Migraine headaches tend to occur on one side of the head and are frequently associated with nausea and vomiting. A traumatic headache, particularly associated with bleeding in the head, may present in the same way as a stroke headache. Stroke headaches are associated with altered levels of consciousness or muscle weakness. Concussions present with a headache and alter mental status. Other conditions that may cause a headache are: dental/tooth pain, infection and drug and alcohol overdoes One important diagnosis a physician must make is to determine if the headache is associated with a brain tumor. These headaches are quite severe and are associated with a wide variety of neurological symptoms.

So what does a physician have at hand to explore the nature and cause of a headache? A very important tool is to take a complete history of the patient, including a detail description of the type of headache the patient is experiencing. Next the physician will perform a physical examination of the patient. The doctor will look for tender spots, abnormal blood vessel sounds or muscle spasms around the head or over the back of the neck. He will look into the retna of the eyes with a special light to see the optic nerve and determine if the optic nerve is swollen or abnormal. Individual muscle strengths and sensations over the entire body are noted. The doctor checks balance and gait when walking and lastly he checks the reflexes in the arms and legs to see if there is an abnormality.