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From Ancient Times to Modern Times: How Do We Understand the Causes of Headaches?
A headache, or cranial pain, is a painful symptom that occurs in the face, head, or neck. Depending on the type, headaches can be classified as migraines, tension-type headaches, or cluster headaches. People with severe headaches have a higher risk of depression, and the causes of headaches vary, including dehydration, fatigue, lack of sleep, stress, medication effects, viral infections, etc.
"About half of all adults experience a headache in a given year, with tension-type headaches being the most common, affecting approximately 1.6 billion people."
Classification of headaches
According to the International Headache Society's classification system, headaches can be divided into two categories: primary and secondary. Primary headaches are those that occur without an obvious underlying disease, are usually benign and may recur, such as migraines and tension-type headaches. In contrast, secondary headaches are caused by underlying health problems, such as brain infection, head injury, or tumor, and can be life-threatening. Understanding these classifications is essential in seeking appropriate treatment.
Primary headache
It is estimated that 90% of headaches are primary and often first occur between the ages of 20 and 40. The most common types are migraines and tension-type headaches, which have distinct symptoms. Migraines are often accompanied by pulsating headaches, nausea, and sensitivity to light and sound, while tension headaches present with a non-pulsating "band-like" feeling of pressure. Although primary headaches are usually not life-threatening, the daily pain and disability they cause cannot be ignored.
"As described in the book, certain headaches, such as cluster headaches, trigeminal neuralgia, and primary stabbing headaches, are relatively rare types of headaches that usually require special treatment."
Secondary headaches
Secondary headaches may be caused by problems elsewhere in the body, some of which are benign (such as cervicogenic headaches) and some of which are potentially fatal, such as meningitis, cerebral hemorrhage, or tumors. Therefore, headache patients should seek medical help promptly when "red flag" symptoms occur. To determine the risk of a headache, your doctor will consider many factors, such as age, how quickly symptoms develop, and whether there are other neurological signs.
Pathophysiology of headache
Although the brain itself does not have pain receptors, there are pain receptors in several areas of the head and neck that can sense pain. Headaches usually result from traction or irritation of the meninges and blood vessels, which may be related to head trauma, tumors, vasospasm, inflammation, or muscle tension. Migraine in particular, current research shows, is related to dysfunction of nerves in the brain.
“Most experts believe that migraines are caused by problems with the nerves in the brain itself, not the blood vessels.”
Diagnosis and treatment
Diagnosis of most headaches usually relies on a description from the individual's medical history. But in cases where headache symptoms sound dangerous, further neuroimaging or cerebrospinal fluid testing may be necessary. For example, headaches that are new or have changed in character require a comprehensive investigation to rule out underlying pathology. For most primary headaches, treatment usually involves pain medication, while treatment of secondary headaches is directed at the underlying cause.
Brain imaging tests
For patients with new-onset headaches, especially those with red flag symptoms, prompt brain imaging is recommended. Computed tomography (CT) and magnetic resonance imaging (MRI) are the most commonly used imaging tests, which can help doctors determine other potential problems in the brain. We also need to pay attention to the application of these technologies to ensure that patients receive appropriate diagnosis and treatment.
Conclusion
Headache is a common disease that has been studied and explored from ancient times to the present, and human understanding of headache has gradually deepened. But when faced with a variety of headache types and causes, can we truly understand the signals from our own bodies to better cope with the discomfort in our lives?
