Doctor advices / Headache

Dr Debnarayanan Dutta | 30/10/2-014

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ADVICES / headache

Dr Debnarayanan Dutta, Consultant Radiation Oncologist, Apollo Speciality Hospital, Chennai

I知 a college student. Whenever I read more than half an hour, I get headache and it lasts for a longer duration. What is the actual cause of the pain in my head and how can I get rid of this problem?               

Shanthini Sinha, Kolkata


Dear Shanthini,

Headache for a long duration needs further evaluation. There may be a number of clinical conditions such as migraine headache, eye problem, sinusitis, spondylitis (cervical bone problem), any brain problem (may be from any benign condition to even potential malignant condition) and those related to psychological disorders. The nature of the headache (like throbbing, dull ache and severe headache), duration (at night or in the evening and early morning) and precipitating cause (studying, watching television, after going out and after stress) indicate the actual cause of headache. 前n and off' headache that precipitates after reading may be due to eye problem and most likely needs refractory error correction (spectacles).

Persons with headache after going out and long work are likely to have sinusitis or migraine. Headache after stress may be due to migraine or psychological (depression) cause. Dull headache, not responding to regular analgesics needs further evaluation with imaging (CT scan or MRI) and clinical examination. There may be any benign or malignant mass in brain or any organic problems in the eye. If there is a sudden, severe headache, there may be any hemorrhage in the brain or eye, and it needs immediate attention.

Arteriovenous malformation (AVM), which is a vascular malformation in the brain, causes headache. Any cyst in brain, bleeding and hydrocephalus cause headache. Epilepsy also sometimes precipitates with headache. Migraine, psychological conditions and sinusitis are usually treated with medicine. AVM is usually treated with surgery, preferably with CyberKnife. Bleeding in the brain may need surgical evacuation.

In short, any headache not responding to regular medications and prolonging more than usual, needs to be evaluated clinically. Organic causes of headache can be treated with modern medicine and complete cure is possible in most causes of headache. We do need to give adequate attention to headache and should never ignore this early sign of a potential life-threatening problem.

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