Headache

Headache is one of the common complaints in teenagers attending clinics.

What causes headache?

What are common causes of headache?

What is the difference between headaches due to stress and migraines?

History	Tension Headache	Migraine
Family History	Nil	May be present
Nature of the pain	Dull ache or like a pressure sensation, distracting but not debilitating	Intense, pounding, throbbing and debilitating
Sites of the pain	Both sides of head, over forehead and temples	One side / both sides of head
Frequency of attacks	Almost daily Gets worst in the afternoon/evening	In episodes
Aggravating / precipitating factors	Stress Skipping meals	Stress Foods like chocolate, cheese, caffeine, orange, tomato and pickled or marinated food Bright light and sun glare Unusual smells Before or after menses
Associated Symptoms / features	Lightheadedness, tiredness, neck pain, perfectionist	Nausea, vomiting, irritability

How to treat these headaches?

Mode of Treatments	Tension Headache	Migraine
Medications	Painkillers	Painkillers Anti – vomiting drugs Drugs to prevent recurrence frequent attacks
Other measures	Relax by lying down Apply cold packs Massage your neck and shoulder	Sleep in a quiet dark room Apply cold packs Avoid coffee, tea or orange juice Do not read or watch television during the attack

How to prevent or reduce frequency of attacks?

Mode of Treatments	Tension Headache	Migraine
Lifestyle Modifications	Learn to relax Be realistic in life Be assertive Learn to control your anger Manage your time well	Avoid known triggering factors Learn how to manage stress and relax Practice regular meals, exercise and good sleep hygiene

What are the danger signs of headache?

If you have these symptoms, consult your doctor immediately:

A headache after head injury
A headache accompanied by fever, vomiting, neck stiffness, blurred vision and weakness of the limbs
A headache that does not go away with usual painkillers
A headache worsened by coughing, sneezing and straining

PORTAL MyHEALTH Kementerian Kesihatan Malaysia