Other Causes of Headaches
Secondary headache disorders are caused by an underlying illness or condition that affects the brain. Secondary headaches are usually diagnosed based on other symptoms that occur concurrently and the characteristics of the headaches. Some of the more serious causes of secondary headache include:
Brain tumor. A tumor that is growing in the brain can press against nerve tissue and pain-sensitive blood vessel walls, disrupting communication between the brain and the nerves or restricting the supply of blood to the brain. Headaches may develop, worsen, become more frequent, or come and go, often at irregular periods. Headache pain may worsen when coughing, changing posture, or straining, and may be severe upon waking. However, the vast majority of individuals with headache do not have brain tumors.
Disorders of blood vessels in the brain, including stroke. Several disorders associated with blood vessel formation and activity can cause headache. Most notable among these conditions is stroke. Headache itself can cause stroke or accompany a series of blood vessel disorders that can cause a stroke. There are two forms of stroke. A hemorrhagic stroke occurs when an artery in the brain bursts, spilling blood into the surrounding tissue. An ischemic stroke occurs when an artery supplying the brain with blood becomes blocked, suddenly decreasing or stopping blood flow and causing brain cells to die.
hemorrhagic stroke is usually associated with disturbed brain function and an extremely painful headache that develops suddenly and may worsen with physical activity, coughing, or straining.
Headache that accompanies
ischemic stroke can be caused by several problems with the brain's vascular system. Headache is prominent in individuals with clots in the brain's veins. Head pain occurs on the side of the brain in which the clot blocks blood flow and is often felt in the eyes or on the side of the head.
Exposure to a substance or its withdrawal. Headaches may result from toxic states such as drinking alcohol, following carbon monoxide poisoning, or from exposure to toxic chemicals and metals, cleaning products or solvents, and pesticides. In the most severe cases, rising toxin levels can cause a pulsing, throbbing headache that, if left untreated, can lead to systemic poisoning, organ failure, and permanent neurological damage. The withdrawal from certain medicines or caffeine after frequent or excessive use can also cause headaches.
Head injury. Headaches are often a symptom of a concussion or other head injury. The headache may develop either immediately or months after a blow to the head, with pain felt at the injury site or throughout the head. Emotional disturbances may worsen headache pain. In most cases, the cause of post-traumatic headache is unknown. Sometimes the cause is ruptured blood vessels, which result in an accumulation of blood called a hematoma. This mass of blood can displace brain tissue and cause headaches as well as weakness, confusion, memory loss, and seizures. Nausea, vomiting, and mild disturbance of brain function also occur.
Increased intracranial pressure. A growing tumor, infection, or hydrocephalus (an extensive buildup of cerebrospinal fluid in the brain) can raise pressure in the brain and compress nerves and blood vessels, causing headaches. Hydrocephalus is most often treated with the surgical placement of a shunt system that diverts the fluid to a site elsewhere in the body, where it can be absorbed as part of the circulatory process.
Headache attributed to idiopathic intracranial hypertension is associated with severe headache. It can be caused by clotting in the major cerebral veins or certain medications (some antibiotics, withdrawal of corticosteroids, human growth hormone replacement, and vitamin A and related compounds). It is most commonly seen in young, overweight females. Weight loss, ending the use of the drug suspected of causing the problem, and diuretic treatment can help relieve the pressure.
Inflammation from meningitis, encephalitis, and other infections. Inflammation from infections can harm or destroy nerve cells and cause dull to severe headache pain, brain damage, or stroke, among other conditions. Inflammation of the brain and spinal cord (meningitis and encephalitis) requires urgent medical attention.
Headaches may also occur with a fever or a flu-like infection. A headache may accompany a bacterial infection of the upper respiratory tract that spreads to and inflames the lining of the sinus cavities. When one or more of the cavities fills with fluid from the inflammation, the result is constant but dull facial pain and tenderness that worsens with straining or head movements.
Seizures. Migraine-like headache pain may occur during or after a seizure. Moderate to severe headache pain may last for several hours and worsen with sudden movements of the head or when sneezing, coughing, or bending. Other symptoms may include nausea, vomiting, fatigue, increased sensitivity to light or sound, and vision problems.
Spinal fluid leak. About one-fourth of people who undergo a lumbar puncture (which involves a small sampling of the spinal fluid being removed for testing) develop a headache due to a leak of cerebrospinal fluid following the procedure. Since the headache occurs only when the individual stands up, the "cure" is to lie down until the headache runs its course-anywhere from a few hours to several days. Occasionally spinal fluid leaks spontaneously, causing this "low pressure headache."
Structural abnormalities of the head, neck and spine. Headache pain and loss of function may be triggered by structural abnormalities in the head or spine, restricted blood flow through the neck, irritation to nerves anywhere along the path from the spinal cord to the brain, or stressful or awkward positions of the head and neck.
Trigeminal neuralgia. The trigeminal nerve conducts sensations to the brain from the upper, middle, and lower portions of the face, as well as inside the mouth. The presumed cause of trigeminal neuralgia is a blood vessel pressing on the nerve as it exits the brain stem, but other causes have been described. Symptoms include headache and intense shock-like or stabbing pain that comes on suddenly and is typically felt on one side of the jaw or cheek. Muscle spasms may occur on the affected side of the face. The pain may occur spontaneously or be triggered by touching the cheek, as happens when shaving, washing, or applying makeup. The pain also may occur when eating, drinking, talking, smoking, or brushing teeth, or when the face is exposed to wind.
Above content provided by the National Institute of Neurological Disorders and Stroke in partnership with Beth Israel Deaconess Medical Center. For advice about your medical care, consult your doctor.
Posted October 2009