With recent advances in neurology, people are becoming more aware of treatment options that are available – whether it’s for something as common as a migraine headache or whether it’s a medical emergency such as a stroke. Here are some of the common questions I hear when people visit my office.
When is a headache more than just a headache?
Almost everyone has experienced a headache, but the pain is usually not sufficient to see a doctor.
In the emergency department, about 1 to 2 percent of patients are admitted for headaches. Of those patients, only about 1 to 2 percent are diagnosed with a serious underlying condition.
When considering whether to seek medical attention for a headache, keep in mind these three tips:
1. No known cause.
2. Sudden.
3. Severe.
Headaches that patients often describe as “the worst headache of my life” can signal an underlying condition such as stroke or aneurism. Headaches associated with meningitis are often accompanied by fever and a stiff neck. In serious cases, a brain scan can help determine what is going on and which treatment options need to be considered.
If you have headaches more than three days a month, that usually warrants the use of preventive medicine, along with medicine to treat the individual headache.
What’s the difference between a migraine headache and another kind of headache?
Most of our patients have been longtime headache sufferers. Often they have been to several physicians and have tried many different medicines before they get to us. About 90 percent of our patients who have headaches have migraines. The difference with migraines is that they are fundamentally a “sick headache” – people will feel nauseated, lose their appetite and feel sensitivity to light and noise.
Can anything be done for migraines?
Recognizing a migraine is sometimes difficult. If there’s been a lack of success with initial therapeutic trials, then it might be time to ask for a referral to a specialist. Specialists will know about all the therapeutic options and how to use them.
The past 15 years have brought several medicines that are specifically good for migraines. These are not pain pills – they have specific actions that help relieve the nausea, vomiting, the sensitivity to light and noise and the overall awful feeling. It takes patience on the part of the doctor and the patient to figure out which medication works for each individual.
What are some of the triggers for headaches?
If you have frequent headaches, maintain a list of food and behaviors to help the track what is a trigger for those headaches. Some of the triggers may be:
Head injury.
Severe sleep deprivation.
Weather.
Dietary issues such as missed meals, or high levels of sugar, or not enough protein or fat.
Exposure to some food, such as red wine or avocado or chocolate.
Smoking.
How can I determine if somebody is having a stroke?
If you think someone may be having a stroke, use the simple acronym F.A.S.T.
Face: Ask the person to smile. Does one side of the face droop?
Arms: Ask the person to raise both arms. Does one arm drift downward?
Speech: Ask the person to repeat a simple sentence. Are the words slurred? Can he or she repeat the sentence correctly?
Time: If the person shows any of these symptoms, time is important. Call 911.
What are some of those symptoms?
Stroke symptoms include:
Sudden numbness or weakness of face, arm or leg – especially on one side of the body.
Sudden confusion, trouble speaking or understanding.
Sudden trouble seeing in one or both eyes.
Sudden trouble walking, dizziness, loss of balance or coordination.
Sudden severe headache with no known cause.
Call 911 immediately if you have any of these symptoms. Note the time you experienced your first symptom. This information is important to your health care provider and can affect treatment decisions.
A stroke is an emergency situation and, like a heart attack, requires immediate medical attention. About 1.9 million brain cells die each minute during a stroke. When considering whether to seek treatment, remember that “time is brain.”
Dr. Dale Overfield is a neurologist with MultiCare Health System.
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