QUESTION: I know that headaches are common and frequent complaints that doctors must hear many times a day.
However I know that there are times when the diagnosis is more serious.
How do doctors tell one type from the other? I think that this information would be helpful for anyone to know.
ANSWER: This is a very good question, and I agree that such information could be helpful to many people.
Here are a few clues.
If the patient complaining of the headache looks sick, I think they deserve a careful examination for other signs that may lead to a diagnosis.
By the same reasoning any other abnormal signs, changes in their walk, muscle strength size of their pupils, or other neurological signs may mean the headache is not a simple one.
If the patient also appears drowsy or confused, the headache may be a sign of serious infection, particularly those that take place within the skull.
The same is true of headaches associated with a fever, which while they may be but the sign of an oncoming common viral infection, can also be the signs of a serious infection such as meningitis.
This may also cause the neck to become stiff, so I always check to be sure the patient can lower their chin to their chest and conduct other tests to be sure the neck is perfectly supple.
Some headaches are provoked by blood leaking in to the brain from aneurysms (a ballooning out of the artery due to weakness in the wall of the vessel) and these must be treated as promptly as possible.
One sign is when a headache has started during exercise or exertion.
Such patient must be carefully examined.
Another headache that must be taken seriously is the "first" headache in an adult patient.
When this occurs, it too may be the sign of a leaking aneurysm.
Remember, however, most headaches are benign, and pass over with rest and analgesics, and don't require intensive care.
The material contained here is "FOR INFORMATION ONLY" and should not replace the counsel and advice of your personal physician.
Promptly consulting your doctor is the best path to a quick and successful resolution of any medical problem.
