Chronic Headaches: Causes, Symptoms, and Treatments

Q: Chronic Headaches: Causes, Symptoms, and Treatments

Hello： The more common causes are tension-type headaches or migraines. <br>The symptoms of tension-type headaches include： 1. <br>Typically bilateral, located in the occipital and parietal regions, sometimes with widespread pain. <br>The nature of the pain is dull, pressure-like,

Headache - has been painful for a long time?

Hello Doctor: I often experience severe headaches that make me feel nauseous, and my eyes hurt.
My blood pressure spikes to 180, my vision becomes blurry, and sometimes I feel like I might faint.
I have had to take painkillers to relieve the pain.
I have been to the emergency room multiple times, but each time I go for an outpatient check-up, the doctors say it's migraines.
However, the medication prescribed does not help.
When the pain is mild, it starts with discomfort in my shoulders and neck, followed by pain in my temples and dizziness.
During severe episodes, the pain intensifies in the back of my head, accompanied by vomiting, palpitations, high blood pressure, blurry vision, and eye strain, requiring me to receive pain injections.
I had an examination at the Veterans General Hospital, but they couldn't find anything.
Recently, I consulted Dr.
Da Qian, who mentioned it could be a "civilization disease." However, I want to investigate the underlying cause.
I am concerned about receiving a superficial examination, so I wanted to ask online for your insights.
Additionally, could you please explain what "non-contrast" imaging entails? Thank you!

Youyou, 30~39 year old female. Ask Date: 2017/06/28

Dr. Jiang Junyi reply Neurology

Hello: The more common causes are tension-type headaches or migraines.
The symptoms of tension-type headaches include: 1.
Typically bilateral, located in the occipital and parietal regions, sometimes with widespread pain.
The nature of the pain is dull, pressure-like, or tight, without pulsation, with tightness and stiffness in the occipital-cervical region, which is noticeable when turning the neck, with intensity ranging from mild to moderate.
2.
There are tender points in the muscles at the pain site, and sometimes pulling the scalp can also cause pain; the muscles may feel stiff, and one or more nodules, referred to as tender nodules, may be palpable.
3.
It does not interfere with daily activities; for example, walking or climbing stairs does not exacerbate the headache.
4.
Pain can be triggered by flexion and extension of the head.
However, women often experience aura-type migraine symptoms: 1.
Visual disturbances may occur, such as seeing stars and lightning-like flashes, as well as blurred or distorted vision, which are all auras of migraines.
2.
A few minutes after the aura appears, the face, hands, or legs may feel tingling, weakness, or numbness.
During the attack, symptoms such as nausea, vomiting, photophobia, phonophobia, and pallor may accompany it.
After the aura disappears, there will be severe, unilateral throbbing pain in the head.
3.
These migraine symptoms usually last for several hours, and can even extend up to 2-3 days.
You mentioned "non-contrast," which may refer to a CT or MRI scan without contrast agent.
I recommend discussing the examination and treatment with a neurologist.
Wishing you good health, peace, and joy.
Dr.
Tao, Neurology, cares about you.

Reply Date: 2017/06/28

More Info

Chronic headaches can be a debilitating condition that significantly impacts daily life. Based on your description, it seems you are experiencing severe headaches that are accompanied by nausea, visual disturbances, and elevated blood pressure. These symptoms can be indicative of several underlying conditions, and it is crucial to understand the potential causes, symptoms, and treatment options available.

Causes of Chronic Headaches
1. Migraine: This is one of the most common types of chronic headaches. Migraines can cause intense, throbbing pain, often on one side of the head. They may be accompanied by nausea, vomiting, and sensitivity to light and sound. The symptoms you describe, such as severe pain, nausea, and visual disturbances, align with migraine attacks.

2. Tension-Type Headaches: These are often caused by stress, anxiety, or muscle tension in the neck and shoulders. They typically present as a dull, aching sensation on both sides of the head and can be exacerbated by poor posture or prolonged computer use.

3. Cluster Headaches: These are less common but extremely painful headaches that occur in cyclical patterns or clusters. They can cause intense pain around one eye and may be accompanied by nasal congestion or tearing.

4. Secondary Headaches: These headaches are caused by underlying medical conditions, such as hypertension, sinus infections, or even more serious issues like intracranial pressure changes or tumors. Given your symptoms of high blood pressure and visual disturbances, it is essential to rule out these conditions.

Symptoms to Monitor
- Nausea and Vomiting: This can indicate a more severe headache type, such as a migraine or increased intracranial pressure.

- Visual Disturbances: Blurred vision or seeing spots can be a sign of migraines or other neurological issues.

- Elevated Blood Pressure: Chronic headaches can lead to spikes in blood pressure, which can further complicate your condition.

- Neck and Shoulder Pain: This may suggest tension-type headaches or issues related to posture and muscle strain.

Diagnostic Tests
You mentioned a desire to understand the term "non-contrast imaging." This typically refers to imaging studies like X-rays or CT scans that do not use contrast dye. These tests can help identify structural issues in the brain or neck that may be contributing to your headaches. However, MRI scans are often preferred for a more detailed view of the brain's soft tissues.

Treatment Options
1. Medication: Over-the-counter pain relievers like ibuprofen or acetaminophen may help, but for chronic migraines, prescription medications such as triptans or preventive medications (e.g., beta-blockers, antidepressants) may be necessary. If the medications prescribed are not effective, it is essential to follow up with your healthcare provider for alternatives.

2. Lifestyle Modifications: Regular exercise, adequate hydration, and maintaining a consistent sleep schedule can help reduce the frequency and severity of headaches. Stress management techniques, such as mindfulness or yoga, may also be beneficial.

3. Physical Therapy: If muscle tension is a contributing factor, physical therapy can help address posture and strengthen neck and shoulder muscles.

4. Neurological Evaluation: Given the severity and frequency of your headaches, a consultation with a neurologist may be warranted. They can perform a thorough evaluation and may recommend further testing to rule out serious conditions.

5. Alternative Therapies: Some individuals find relief through acupuncture, chiropractic care, or biofeedback.

Conclusion
Chronic headaches can be complex and multifactorial. It is crucial to work closely with your healthcare provider to identify the underlying cause and develop an effective treatment plan tailored to your specific needs. If your symptoms persist or worsen, do not hesitate to seek further medical evaluation. Remember, managing chronic headaches often requires a comprehensive approach that includes both medical treatment and lifestyle adjustments.

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