HeadacheHope Through ResearchNational Institute of Neurological Disord - PDF document

HeadacheHope Through ResearchNational Institute of Neurological Disorders and Stroke Stroke or any other Federal agency. Advice on the patient’s medical history. Table of Contents You’re sitting at your desk, working on a difcult head pain that just won&

#146;t go away.and recur later in life. It’s or twice a year, while others Headaches are the most common form of pain and range in frequency and severity. Without proper treatment headaches can interfere with work or school as well as visits to the doctor. Head

aches and lost productivity. Indirect costs are difcult to Without proper treatment, headaches can be severe and Terms in italics appear in the Glossary found at the end of this document. brain’s “relay station” for pain sensation from all over th

e body, and then onto the parts of the cortex (the brain’s outer layer) involved in sensory and emotional Not all headaches require a physician’s attention. headaches, however, should be seen by a doctor. This  Very sudden, severe headache that may be 

Severe headache accompanied by fever, nausea, or  Sudden “worst” headache, often  or behavior. A very sudden, severe stiff neck, or by fever, nausea, 4  Headache following a head injury.  weakness in any part of the body, which could  He

adache associated with convulsions.  Headache associated with shortness of breath.  New onset of two or more headaches a week.  Persistent headache in someone who has been  New headaches in someone with a history of  Diagnosing Your Headacheprescrip

tion and nonprescription over-the-counter at that time. Women should record the days of their disorder. A pattern may emerge that can be helpful to system. Testing a sample of the uid that surrounds the brain tumors and cysts, brain damage from head injury, a way

to see what’s happening in the brain during brain tumors, seizures, head injury, and inammation Headache Types and Their TreatmentThe International Classication of Headache Disorderswww.ihs-classication.org/en/International Headache Society, is use

d to classify more disorders. The major types are discussed below. caused by another medical condition. It’s uncertain cortical spreading depression increased sensitivity to light, noise, and odor, as well as nausea and vomiting. Routine physical activity, 7Migra

ines occur most frequently in the morning, especially upon motion sickness, low blood sugar, skipped meals, tobacco, depression, anxiety, head trauma, hangover, the disorder. They also frequently occur in people who have other medical conditions. Depression, anxiety,

bipolar disorder, sleep disorders, and epilepsy are of the rst menstrual cycle or during pregnancy. worsens migraines. Women with migraine who take  Premonitory  Aura. Some people will see ashing or bright 9 builds in intensity. possible, however, to

Postdromepeople feel healthy. are premonitory, aura, However, all of the phases Types of Migraine. The two major types of migraine are: usually last no more than an hour. Individuals 10Other types of migraine include:  Abdominal migraine mostly affects young child

ren and involves moderate to severe pain in the middle  Basilar-type migraineof basilar-type migraine are more frightening than basilar-type migraine have a greater risk of stroke.  thereafter. When it runs in families the disorder 11  Menstrually-related mi

graine affects women around the time of their period, although most  suggested that fever, dizziness, and/or unexplained  Retinal migraine is a condition characterized  can last 72 hours or longer. The pain and nausea may Migraine Treatment.during a migrain

e’s early stages. soon as symptoms occur. Preventive treatment involves  Triptan serotoninTriptans—the preferred treatment for migraine—  Ergot derivative drugs  Non-prescription analgesics or over-the-counter  Other non-prescription analg

esics or over-the-  Prescription or nonprescription nonsteroidal anti- 13  Nausea relief drugs can ease queasiness Narcotics are prescribed Taking headache relief relieved temporarily. For example, taking triptan or worse. Taking more of the drug to treat a new

headache severe and may occur with nausea or irritability. It may frequency. Preventive medicines are also recommended 14Several preventive medicines for migraine were initially marketed for conditions other than migraine.  epilepsy, but these drugs can help preven

t  Beta-blockers are drugs used to treat high blood  Calcium channel blockers are medications that  Antidepressants may be helpful for individuals Natural treatments for migraine include riboavin of pain and the body’s response to stress. prevent

ion. The current stimulates the trigeminal nerves. Tension-Type HeadacheTension-type headache is the most common type of contracting muscles in the neck, face, scalp, and jaw. Tension-type headaches may also be caused by jaw anxiety, or too little sleep. Sleep apnea ma

y cause Typically, tension-type Tension-type headaches—the most common type of headache—may feel as if a belt or “vice” is being Tension-type headaches affect women slightly more helped by corrective devices for the mouth and jaw. history of sno

ring, daytime sleepiness, or obesity. disease. Triptan drugs, barbiturates (drugs that have a headaches. Physical therapy, massage, and gentle Cluster Headache and Trigeminal head pain), differ in attack duration and frequency, occur on a daily or near-daily basis for

weeks or occur on a daily or near-daily basis for a year or swollen, and teary. Some Cluster headaches involve sudden, extremely painful day or night. They can be provoked by alcohol, especially red wine, and smoking. less frequent and shorter than migraines. It’

;s common periods a year, separated by months of freedom from symptoms. The cluster periods often appear seasonally, chronic form of the disorder, which is characterized by day, suggesting they could be caused by irregularities in the body’s sleep-wake cycle. Alco

hol (especially red Treatment options include oxygen therapy—in which occur 5 to 40 times per day, with each attack lasting 2 particularly if taken when symptoms rst appear. (Short-lasting, Unilateral, Neuralgiform headache attacks with Conjunctival injecti

on and Tearing) is a very follow a pattern of increasing and decreasing intensity. 5 seconds to 4 minutes per episode. Individuals generally have ve to six attacks per hour and are pain-free between annually with headaches that remit and recur, or chronic, lasting

more than 1 year. Occasionally SUNCT occurs Symptoms include reddish or bloodshot eyes (conjunctival Other Primary Headaches use may increase headache severity. The disorder is Chronic daily headache occurs at least 15 days a month during a 3-month period.New daily

persistent headache (NDPH), previously called chronic benign daily headache, is known for its constant daily pain that ranges require treatment, and a longer-lasting form that is year while others may have multiple headaches daily. by coughing or sneezing or intense

physical activity. Warm-up exercises prior to the physical activity can 24 headache may be a disorder of rapid eye movement (REM) Both men and women are affected by this disorder, which is usually treated with caffeine, indomethacin, or lithium. fast, you may have had

what’s called an disorders are caused by an underlying endings to be pressed on or pulled or pushed out of place. Treatment depends on the primary disorder. Some examples of underlying conditions include fever, infection, Brain tumor.headache have a brain tumor

. However, a tumor that and may be severe upon waking. Treatment options include surgery, radiation therapy, and chemotherapy. Hemorrhagic stroke is typically associated with disturbed brain function and an extremely painful, sudden headache. venous strokes (caused by

clots in the brain’s veins) and persons with dehydration, cancer, or infections. Hemorrhagic stroke, which occurs when a brain artery bursts and spills blood into the surrounding tissue, is typically associated with an extremely painful, sudden headache.(AVM),

an abnormal tangle vary in frequency, duration, AVM (although most one-sided noises. Treatment options include blocking the blood or through focused radiotherapy or surgery. brain’s vascular system. Conditions of ischemic stroke  artery that supplies the bra

in with blood ow. The occurs. Vertebral artery dissection causes pain in  Cerebral vasculitis, an inammation of the brain’s reversible cerebral vasoconstriction syndrome Arterial dissection—a tear within an artery that supplies blood to the bra

in—are usually caused by neck strain such as pronounced bending of the head backwards over a sink for hair washing. Dissections can cause lead to stroke and cause headache. Head injury.concussion or other head injury. The headache may and blood vessels, causing he

adaches. Two disorders Inammation from infections can harm increased sensitivity to light or sound, and vision problems. treated by injecting a small amount of the individual’s spontaneously, causing this “low pressure headache.” Trigeminal neura

lgia.sensations to the brain from the upper, middle, and lower portions of the face, as well as inside the mouth. A potential intense shock-like or stabbing pain that comes on suddenly and is typically felt on one side of the jaw or cheek. Headaches are common in child

ren. Headaches that begin early in life can develop into migraines as the child grows older. Migraines in children or adolescents can develop including emotional problems, stress, weather changes, irregular sleep and eating, dehydration, and certain foods injury or t

hose accompanied by rash, fever, or sleepiness. where it hurts, how often the headaches occur, and television or use the computer, or when the child stops not a child is able to eat during a headache. Very young includes rest, uids, and over-the-counter pain relie

f for migraine pain in children age 12 and older, and can be treated with over-the-counter medicines that on the child’s age and weight. Headaches in some relaxation/behavioral therapy. Children with cluster 33A variety of headache education and drug and/or behav

ioral management approaches are now under share with their health care practitioner. pain. Generally, too little or too much sleep can precipitate Check with a doctor before using over-the-counter her doctor, and honest course of treatment. Avoid using over-the-co

unter disabling. This drawing vividly illustrates how devastating headache pain can be. your headache, stress, and emotions worsened headache pain and frequency of attacks. Visit What Research is Being Done by NINDS? 35of the National Institutes of Health, the leadin

g supporter of biomedical research in the world.The NINDS conducts and supports three types of research: basic—fundamental lab-based studies of clinical—the testing — the creation of tools that speed the practice. The goals of this research are to inc

rease prior to or during a migraine—remain unclear. migraine pathophysiology. Related research hopes in pain and visual pathways. Scientists are exploring the role of the molecule Mast cells, which are part of the immune system and are involved in the in

;ammatory allergic 37 Higher levels of calcitonin gene-related peptide (CGRP) are associated with light-avoiding behaviors in mice, which may serve as a model of a common symptom reported by people affected by migraines. Using optogenetics, a method of turning neuron

s on or off with a beam of light, scientists identied brain regions involved in this response. In this image, green bers can be seen projecting from the posterior nuclei of the thalamus (a sensory processing area) up to the cortex (the outer layer of the brai

n). Surrounding brain cells are stained with a blue dye. The results from these experiments may help identify new therapeutic targets for the receptor potential ankyrin-1 (TRPA1), may contribute to headache and a variety of headache disorders. TRPA1 TRPA1 activation an

d related headache pain may Cortical spreading depressionactivity, followed by decreased activity, slowly spreads along the brain’s surface. The wave of brain activity function and causes swelling in the brain’s nerve cells. in the membranes around the brain

. Additionally, Genetics may contribute to a predisposition for migraine. conditions such as asthma/allergy, cardiovascular disease, depression/anxiety, and epilepsy. nd safer, more effective doses for focuses on genetics. Researchers location, and certain genes

However, overuse of these drugs to treat episodic anatomical, molecular, and behavioral approaches well as into migraine mechanisms more broadly. gender-related differences in brain structure and ow, oxygen metabolism, and tissue oxygenation in help scientists

assess the brain’s physiological status during migraine and its response to therapy, with evaluating and comparing the structure, chemistry, and comparing the structure, chemistry, and function of (pre-puberty, at puberty, and in adolescence) have Measures of mig

raine’s effect on the prepubescent brain NINDS-funded scientists are using brain imaging technologies such as MRI to study gender-related differences in brain structure and circuitry in people with migraines. obesity, chronic pain, and migraine. Behavioral (the b

ody’s clock that regulates the roughly NIH and NINDS—Expanding Pain Research Training the next generation of headache researchers disorders. Currently, several new or early stage Where can I get more information? Disorders and Stroke, contact the Institute&#

146;s Brain P.O. Box 5801www.ninds.nih.govRePORTER (http://projectreporter.nih.gov P.O. Box 850www.theacpa.orgwww.achenet.orgNew York, NY 10021www.migraineresearchfoundation.orgwww.headaches.org Glossarya warning of a migraine headache. Usually visual, it may appear as

ashing lights, zigzag lines, or a temporary occurring involuntary. The autonomic basilar-type migraine— sudden, extremely painful headaches the front of the brain’s surface and may be the basis the headaches temporarily, over time the underlying headac

he becomes worse and occurs more frequently, They are moderate to severe in intensity, associated and worsen with routine physical activity. a type of migraine that is characterized temperature, sleep, vomiting, sexuality, and appetiteTearing)—recurrent bursts of

moderate to severe burning, stabbing, including watery, reddish eyes, and runny nose routine activity. It may be brought on by stress. page 34, Dr. Rami Bursteinpage 37, Dr. Levi Sowers, University of Iowa Prepared by:Ofce of Communications and Public LiaisonNIH P