Deciphering Headaches, Migraines

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Kuala Lumpur, June 8: Headaches can be brought on by a variety of causes, but some individuals can find it difficult to carry out simple tasks or daily activities when these headaches become more serious or when they also begin experiencing migraines.
In Malaysia, tension headaches are the most prevalent (26.5 per cent), followed by migraines (nine per cent) and a range of other types of headaches (28.2 per cent).
Dr Kok Chin Yong, Consultant Neurologist and Internal Medicine Physician from Sunway Medical Centre Velocity (SMCV) shares that tension headaches and migraines can turn into chronic headaches with studies showing that two per cent of patients with migraine turned to have chronic migraine each year.

Dr Kok Chin Yong. Image supplied.

“Chronic headaches are defined as headaches that last 15 days or more in a month, for more than three months. Chronic headaches should not be taken lightly – while it may not always be a marker of something serious, one should seek medical attention if the headache is accompanied by other symptoms such as numbness, weakness, difficulty speaking and walking, visual disturbance, fever and loss of weight,” Dr Kok explains. 

Headaches are a common occurrence and can be brought upon by many factors, but they should not be taken lightly, especially in chronic cases or migraines. Image supplied.

Triggers and treatments 

Dr Kok shares that most patients have episodic headaches that come and go, with some needing little to no painkillers to manage the pain. Half of the patients with chronic headaches also suffer from what is called a medication overuse headache (MOH), which is largely underdiagnosed but can be treated by managing the usage of painkillers to reduce its severity.
“Migraines can be debilitating and affect one’s life and work. It can worsen with physical activity, affecting focus and concentration and in return reducing one’s efficiency at the workplace. Episodic migraines can be prevented from turning into chronic migraines by taking good preventative medications and making lifestyle changes,” he said.
These lifestyle changes include regular exercise, managing stress levels and getting proper hours of sleep.
“Non-drug strategies are crucial as they can worsen and trigger migraines. One needs at least seven hours of good quality sleep – do not consume alcohol in order to sleep or take caffeine later than 3 pm as it affects your sleep quality. High screen time can also trigger migraines, especially in young adults, and these patients are sensitive to lights and flickering sounds, which can also worsen migraines.
“The key to preventing migraines is regularity. Patients with migraines need to have regular eating and sleeping time, as a lack of it can trigger migraine attacks. If someone has a high frequency of migraine attacks, one has to be aware that there are good and effective preventative medications to reduce the burden. Some come in the form of pills and some in the form of injections. The latter is very easily administered and can reduce the frequency and severity of migraine attacks.”

Dr Gerard Arvind Martin. Image supplied.

Indicators of more serious health issues  

Dr Gerard Arvind Martin, Consultant Neurosurgeon from SMCV adds that patients with gradually or worsening headaches can occasionally be diagnosed with life-threatening neurosurgical conditions and, if left untreated, could be fatal.
He shares that some headaches can be signs of anomalies such as tumours, which can then result in a headache that may involve the entire head or part of it.
“We have seen this to be especially true for those whose headaches are caused by tumours or vascular conditions such as aneurysms. A tumour may announce itself by affecting that specific area it is pressing against or developing in, therefore causing those symptoms related to that part of the brain. A growing tumour may grow, either quickly or slowly over time, and push aside the brain, causing the brain to react to tumour tissue and brain swelling occurs, and headache ensues,” he adds.
Aside from these headaches, patients should also look out for other affected neurological functions such as impairment of decision making, thinking and memory. The presence of a seizure, either before, during or after the onset of headaches can also be an accompanying feature of brain tumours.
“When a patient comes to a hospital with some or all of these symptoms, a preliminary CT scan is done, with an MRI in due course depending on the initial CT finding and proposed treatment route.
However, Dr Gerard reassures patients that not all headaches are an indication of a serious neurological condition and that they should rule out other causes first.
“While it is alarming yet almost natural to think that all bad headaches are always caused by something sinister occurring within one’s head, the truth is that headaches can also be caused by other parts of the head such as the eyes, ears, neck, the sinuses or even teeth. Therefore, it is also good practice to rule out anything occurring in these areas as well during the initial consultation.
“Those who act upon their symptoms in a timely manner and get themselves treated are able to mitigate their conditions and, depending on the diagnosis, able to continue to lead fuller lives,” Dr Gerard concludes. 

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