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

What causes headache?

  • Infections
  • Tension headache
  • Migraine
  • Bleeding in the brain and surrounding structures
  • Tumor in the brain
  • Dental problems:
    • Tooth abscess
    • Infected gum
  • Eye problems:
    • Eye strain
  • Ear, Nose and Throat problems:
  • Infection of the sinus (Sinusitis)
  • Ear Infection
  • Psychosomatic disorder

What are common causes of headache?

  • Migraine
  • Tension

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

Tension Headache
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
  • 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
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
Last Reviewed : 28 August 2020
Content Writer : Dr. Salmiah bt. Md. Sharif
Reviewer : Dr. Nazhatussima bt. Suhaili