Causes of headaches

If the headache that you are suffering, or that your friend is getting, is new-by which I mean that either you never had headaches in the past, or even if you had them, the current one is significantly different from your previous ones, then consult your neurologist! New-onset headache should lead one to worry about some new problem, potentially serious. For instance, take a migraineur who habitually gets attacks once a week, and always has pain starting on one side, say the temple on one side; the headache usually lasts 6 hours,and she wakes up fresh and headache-free. Now, she says that for the last 5 days she has had continuous headache, she even wakes up with the headache, and it if felt all over the head: alarm bells would start ringing in the neurologist's ears, since this is a new phenomenon. It could signal some serious problem, like a brain tumor, or an abscess, or some other space-occupying lesion in the brain; or it could be some condition which has raised the pressure inside the skull (raised intra-cranial pressure). The important thing is to get examined by a neurologist, and based on his assessment go ahead with some investigations. The headache need not have all the characteristics I mentioned; a change in even one of the things should be enough to make you consider this option. So you need to think about your headaches in the following descriptive terms: Frequency: how frequently do I get this headache? (whenever I go out in the sun, or when I worry about something, is not good enough; try to get an idea of the frequency in a calendar period, say a week or a month). Duration: on average, how long does the headache last? (It need not have pin-point accuracy: does it last only 1-2 hours, or 6-8 hours, maximum of 24 hours, or does it last closer to 36-48 hours; 72 hours or sometimes 3-4 days or even longer. I frequently get patients who think for a while and then come up with the claim that there is no consistency, and they select all these options; while this is occasionally possible, it generally reflects the fact that the sufferer has never really kept a check, which is not such a blunder, but the question makes the responder defensive! I usually ask the person to keep a watch in the next few occasions). Other questions to be answered are regarding the location, the severity, the pattern of spread, the relieving factor and so on. I will discuss these aspects based on the input I get from readers.