headache - Medical Dictionary

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headache		The symptom of pain in the cranial region. It may be an isolated benign occurrence or manifestation of a wide variety of headache disorders. [ Articles \| Books \| Images \| Discussion groups ]

Additional comments : (Cephalgia) Sleep disorders may cause cluster headaches The majority of people with cluster headaches may also have sleep disorders that trigger the attacks, according to the scientific journal of the American Academy of Neurology. Cluster headaches, which often occur during the night, are attacks of stabbing pain on one side of the head. Attacks often come in groups, several times a day or week, and then may disappear for weeks or months. For the study, 25 people with cluster headaches were evaluated in a sleep laboratory. Of those, 20 people, or 80 percent, showed some signs of obstructive sleep apnea, a condition in which the upper airway closes during sleep, breathing stops, and sleep is briefly but repeatedly disrupted throughout the night. In the study, those people who reported that their headache attacks typically started in the first half of the night tended to have more severe drops in blood oxygen levels. Researchers don't know why many people with cluster headaches have sleep apnea, but one hypothesis is that the hypoxemia, or lack of oxygen in the blood, that occurs when breathing stops may trigger the attacks. The argument is bolstered by the finding in this study that more severe hypoxemia seemed linked to the early nighttime timing of the headaches. Cluster headaches, which are more common in men, usually last anywhere from 15 minutes to three hours. Related symptoms include eye-tearing or redness, a runny or stuffy nose, and facial sweating -- all occurring on the side of the head where the pain is felt. Source: American Academy of Neurology New treatment for whiplash induced headaches Americans spend millions of dollars each year to cope with headaches. Many of those headaches are linked to whiplash in car accidents, sudden falls or head trauma. In 1994 alone, a million drivers were rear-ended and 500,000 were injured. That sudden jolt from behind whips heads back and forth and puts excess pressure on the neck’s 14 joints that connect the skull to the spine. One of those joints near the base of the skull is called C2-3. Every year about 30,000 people in car accidents and other whiplash traumas end up with damaged C2-3 joints. Some have unrelenting head pain and quit work, completely disabled. A team of doctors at the University of Pennsylvania’s Department of Rehabilitation Medicine has demonstrated a new and successful treatment for headaches linked to C2-3 joint injury. In a retrospective study focused on eighteen patients who had daily pain, a steroid was injected through a small needle directly into the neck joint’s synovial cavity lining to reduce inflammation. The result was almost miraculous for 11% of patients who were completely free of pain afterward. Another 61% had fewer than three headaches a week that were relieved by common oral pain medicine. Since migraine headache and joint C2-3 symptoms are similar – pain behind the eye, in the forehead and severe nausea – researcher does a test injection of a local anesthetic in the joint to see if headache is relieved. When joint damage is the cause, the headache will usually subside in a few minutes. Source: University of Pennsylvania School of Medicine Gluten in the diet may be the cause of recurring headaches It may be worthwhile to consider how much wheat you eat if you suffer from headaches or lack of coordination and have gluten sensitivity. Researchers found that removing or cutting back on gluten – a protein in wheat and other grains --in the diet greatly reduced these symptoms among a middle-aged study group. The study was reported in the scientific journal of the American Academy of Neurology. The study reported 10 patients with gluten sensitivity whose MRI (Magnetic Resonance Imaging) tests suggested inflammation of the central nervous system. All had experienced occasional headaches and some suffered from unsteadiness and failure of muscle coordination. After removing gluten from their diets, nine of the 10 patients in the study found full or partial relief. One patient would not try the diet. In one of the cases, a 50-year-old man developed headaches and nausea along with confusion and agitation. He had experienced episodic headache for four years but then the attacks progressed in frequency and severity. After starting a gluten-free diet his balance improved rapidly and his headaches cleared completely. After a relaxation of the gluten-free diet, his intermittent headaches returned. Source: American Academy of Neurology Obesity linked to risk of severe headaches Obesity is linked to a risk of severe headaches, according to research presented at the American Academy of Neurology 57th Annual Meeting in Miami Beach, Fla., April 9 – 16, 2005. The study measured the influence of body mass index on frequency, severity, and the potentially disabling effects of headaches. An individual's body mass index helps to determine his or her individual weight-related health problems according to height and weight. Out of 143,433 participants reached by phone, researchers identified 30,850 people who had at least one severe headache attack in the previous year and took weight and height assessments. Participants were categorized into four body mass index types: underweight, normal weight, overweight, and obese. A fifth group of morbidly obese individuals was also analyzed. Results indicated that chronic daily headaches are more prevalent in obese and morbidly obese people than those with normal body weight. The majority of respondents were female (64 percent) and had an average age of 43. Thirty-three percent of the obese people missed more than four days of work in one year because of a severe headache, compared to 27.2 percent of overweight people, 27.2 percent of normal weight people, and 26.1 percent of underweight people. Obese people also reported severe pain more often than the other groups. Those with morbid obesity reported that the pain was usually severe 40.2 percent of the time. The length of time the headaches were endured did not differ significantly among the groups. Source: American Academy of Neurology Spinal cord stimulators tested as treatment for patients with migraine headaches Researchers at Rush University Medical Center are testing a new treatment for migraine headaches: occipital nerve stimulation, a surgical procedure in which an implanted neurostimulator delivers electrical impulses to nerves under the skin at the base of the head at the back of the neck. This therapy may help migraine sufferers who do not respond to other available therapies, or who cannot tolerate the side effects of existing medications. The study, known as PRISM (Precision Implantable Stimulator for Migraine), uses Boston Scientific's Precision neurostimulator with approximately 150 patients at up to 15 sites in the U.S. The implantable pulse generator will deliver electrical impulses to the occipital nerves located just under the skin at the base of the skull at the back of the neck. The Precision device is the smallest rechargeable neurostimulator on the market today and is already approved by the FDA for spinal cord stimulation to treat chronic pain. The smallest rechargeable neurostimulator available, the Precision device has been used in the treatment of more than 6,000 patients suffering from chronic pain, according to Boston Scientific. The Precision neurostimulator is currently FDA approved for spinal cord to treat chronic pain by precisely delivering tiny electrical signals to the spinal cord that mask the perception of pain. Spinal cord stimulation is prescribed for patients with chronic pain in the limbs, trunk and back. Source: Rush University Medical Center The evolving management of migraine Prevention can help avoid overmedication Therapy to prevent migraines can be more effective than attempting to treat pain after the migraine process has begun, according to researchers. About 25 to 30 million Americans experience migraine headaches and many more are undiagnosed. Migraine is more prevalent in women: 18 percent of women and six percent of men (12 percent of the overall U.S. population) are affected by migraine headaches. The annual cost of migraine is 17 billion dollars in health care and lost labor costs in the United States alone. Dr. Silberstein commented that some patients who have episodic (occasional) migraines (the most common) eventually develop chronic migraines (those that occur more than 15 days per month; occurs in 2 percent of patients.) There are many risk factors for chronic migraine, Dr. Silberstein said, such as obesity, snoring, stressful life events and overuse of pain medications, among others. Patients often unwittingly aggravate the frequency and severity of their migraine by taking too much acute medication, causing medication overuse headache. The International Headache Society has recently released guidelines that define overuse of acute medications as the use of opioids, triptans or combination analgesics for more than 10 days per month or simple analgesics (pain relievers such as aspirin or ibuprofen) for more than 15 days per month. Source: American Medical Association

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