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WARNING!

Headache

Although most headaches are harmless, some may be a warning sign of a serious underlying problem. Call 911 or your local emergency number or go directly to the nearest hospital emergency department if your headache is severe and persistent, if it occurs after a blow to the head, or if it is accompanied by any of the following symptoms:

• Fever

• Nausea or vomiting

• Stiff neck

• Pain in the eye or ear

• Dizziness, confusion, or loss of consciousness

• Weakness, numbness, or paralysis

• Seizures

Migraines

A migraine is a severe, persistent headache that usually starts on one side of the head and spreads to the other side as it gradually increases in intensity. For many people, migraines can be disabling. Because migraines tend to run in families, doctors think that there may be a genetic component.

During a migraine, the arteries leading to the brain first become narrowed and then become dilated (widened) by nerve impulses inside the brain. Doctors believe that these changes in the diameter of the arteries produce the pain of a migraine. Narrowing of the arteries reduces blood flow to various parts of the brain, which may help explain some of the sensory disturbances—such as increased sensitivity to light, noise, or odors—that can accompany a migraine.

In many cases, specific substances, conditions, or circumstances trigger a migraine. Common triggers include consuming alcohol, chocolate, caffeine, monosodium glutamate (MSG) in processed foods, nitrates or nitrites in processed meats, and tyramine in cheese or red wine. Other possible triggers include exposure to fluorescent light, glaring light, high altitudes, strong odors, or sudden changes in environmental temperature or barometric pressure. For some women, migraines are associated with menstrual periods. Other people may develop migraines during or immediately following times of emotional stress.

Migraines seldom occur before puberty, but most people who have migraines usually have their first one before age 40. Migraines are more common in women than in men.

Headache Diary

Keeping a headache diary can help you determine what triggers your headaches so you can take steps to prevent them in the future. Bring your headache diary with you when you visit your doctor. The information it contains will help your doctor identify the cause of your headaches and plan appropriate treatment. Whenever you have a headache, write down the following information:

• Date

• Time the headache began

• Time the headache ended

• Intensity of pain (such as mild, moderate, or severe)

• Type of pain (such as aching, throbbing, or stabbing)

• Location of the pain

• Other symptoms (such as nausea, vomiting, or sensitivity to light)

• Medication taken for headache (type and amount) and results

• Self-treatment for headache (such as sleep, cold compresses, or relaxation techniques) and results

• Activity you were engaged in when headache began (such as working or exercising)

• Where you were when the headache began (such as indoors or outdoors)

• Potential allergens nearby when the headache began (such as pollen, tobacco smoke, dust, or pets)

• Other environmental factors (such as noises, odors, or room temperature)

• Food or drink you consumed before the headache began

• Your emotional state (such as angry, stressed, or tired) before the headache began

• Medication you are taking for other reasons (both prescription and over the counter)

Symptoms

The main symptom of a migraine is intense, throbbing pain that gets worse. The headache is usually accompanied by other symptoms—such as nausea, vomiting, diarrhea, aches, sweating, or extreme sensitivity to light or noise—that can vary from one person to another. Your eyes may be bloodshot and your skin may appear abnormally pale. Other symptoms may include numbness or tingling around your mouth or in one arm or down one side of your body, dizziness, ringing in your ears,