Tension-type
headaches
It's as if your head is encased in a helmet which is far too
tight, or even trapped in a vice which is gradually being tightened
- this is how many patients describe tension-type headaches.
Nearly all of them say that it is a dull ache or dragging pain
on both sides of the head - pain which not uncommonly radiates
to the back of the neck, the shoulders and even the back. It
is often accompanied by unpleasant symptoms such as nausea and
dizziness. The lucky ones only have such headaches for a few
hours, but with the less fortunate they can go on for days.
If these headaches only occur occasionally, the doctors speak
of episodic tension-type headaches, but if they occur daily
over a period of at least six months, they are deemed to be
chronic.
This most common of all headache types appears to be caused
by the sufferer being "under stress or tension"
which leads to headaches. Hence the name! And how often in
your life are you under stress as a result of time pressure
and the pressure to perform, for example. You have to grit
your teeth (a strain on the jaw), hold your head up (neck
muscles), at worst stick out your neck (neck muscles), straighten
up your shoulders (shoulder muscles). Apart from physical
stress, purely mental stress, such as constant arguments with
one's partner, can also lead to ("psychogenic")
tension-type headaches.
Cluster headaches are rare
The most severe of all forms of headache, cluster headaches,
is fortunately rare: only 0.5 per cent of all men and 0.1
per cent of all women who suffer from headaches have this
type of primary headache, the cause of which is to a large
extent unknown. Cluster headaches are so called because they
occur in clusters at certain times of the year, in spring
and autumn more than at other times. Do you have unbearable
headaches on only one side of your forehead or in only one
eye socket which radiate into your upper jaw? Do you suffer
from these headaches, which last from a quarter of an hour
to an hour and a half, several times a day? And are you then
pain-free for months at a time? Then you are most likely one
of the unfortunate victims of cluster headaches! Especially
if these headaches are accompanied by allergy-type symptoms
such as red eyes, contracted pupils, watery eyes and a runny
nose.
But there is a great deal you can do to get rid of them permanently.
In about 50 per cent of all cases, alcohol is the trigger.
Other triggers are nicotine, glaring lights and high altitudes.
All of which can be relatively easily avoided! But if you
continue to suffer from cluster headaches, your doctor will
prescribe you medication which is also used to treat migraine
patients.
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Infernal headache accompanied by diabolical symptoms:
Migraine
One distinctive feature gave migraine its name almost
two thousand years ago: Galen, the Greek personal physician
of the Roman emperor Marcus Aurelius called it "hemicrania"
- half skull. And indeed, most migraineurs say that they only
experience the infernal headache on one side of their head.
As a migraineur, do you occasionally have cravings for certain
foods? Are you suddenly dog tired from one day to the next,
even though you have had a good night's sleep, or are you
- on the contrary - almost hyperactive? Are you irritable
or in a bad mood with no good reason? Or depressed or anxious?
All these can be "early warnings" (in technical
terms "prodromal symptoms") of an approaching migraine
attack. One in three of those affected suffer from migraines
with this type of "warning", which brings unpleasant
symptoms in its wake: nausea and even vomiting, great sensitivity
to noise and light. This is why migraineurs prefer bed rest
in a darkened, quiet room during an attack, which can last
for up to three or four days. This sounds anything but simple,
and yet doctors call this type of migraine "simple migraine"
or "migraine without aura".
Or on the other hand does it start with flickering and shimmering
in front of your eyes, do you see a haze and streaks or zigzag
lines resembling an old fort (hence the technical term fortification)
or even a persistent "blind spot" (technical term:
scotoma)? You also begin to feel a tingling in your limbs,
your hands and legs feel numb, as if you are paralysed, and
you find it hard to speak clearly. These symptoms become more
and more severe until, from one minute to the next, a hammering,
throbbing or pulsating headache starts, usually around one
of your temples or one eye. If this is what happens to you,
then you have migraine with aura. Clearly, the disturbances
radiate from the brain to all parts of the body. The headaches
which begin after the appearance of the aura are generally
shorter than in the case of simple migraine. If you are one
of the lucky ones, it will disappear after a few hours just
as suddenly as it came.
If the symptoms of aura last longer than an hour, the doctors
speak of migraine with extended aura ("complicated migraine").
If disturbances such as the "blind spot" last longer
than a week, then there is the risk of a "migrainous
infarction", possibly even a stroke.
Like cluster headaches, acute migraine attacks can be caused
by certain "risk factors" or triggers. These can
vary from one sufferer to another.
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