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“НАШЕ ЖИТТЯ”, ЛЮТИЙ 2014 WWW. UNWLA.ORG 33 HEAD ACHES Ihor Magu n, MD, FACP H eadaches top the list of health issue s a d- dressed in a medi cal office. It is a symptom that can either be a sign of a benign disorder (most common) or a catastrophic condition. The International Headache Society has developed a classification of headaches — primary , defined by symptoms such as migraine or tension, and secondary , def ined by cause such as infe c- tion , blood vessel issues (stroke, hemorrhage), brain tumor, hypertension, drug withdrawal , or trauma. This article will focus on the much more common primary headaches — migraine and te n- sion. Headaches are mostly diagnosed with a detailed history and physical examinati on. D e- spite the concerns one may have about a possible brain tumor or lesion, these are not common and frequently do not presen t as headaches , but r a- ther through neurological abnormalities. Thus, routine MRI or CT scans are not typically pe r- formed unless medically warranted. There are a fairly large number of ind i- viduals who have recurrent headaches of the m i- graine type. Interesti ngly, migraine headaches are more common in pread olescent boys than girls, but in adulthood , more women than men present with this condition. There is usually a peak in the fifth decade, a dip in the sixth and seventh de c- ades , with very few cases occurring in later de c- ades. Th ere is extensive variability in present a- tion of migraine headaches. The typical migraine is a throbbing, unilateral pain and can be acco m- panied by what is defined as an aura. An aura is an abnormality that can be visual, sometimes a c- co mpanied by numbness , and usually occur ring five minutes to one hour prior to the headache. Occasionally headaches do not follow the aura. Risk factors for migraine he adaches i n- clude stress , the female gender, high caffeine i n- take, smoking , and overtreatmen t of ac ute hea d- aches with medications — a condition referred to as medication overuse headache. This condition is being seen more frequently as more and more patients self - medicate in excess . This issue must be discussed with your physician. T reatment option s using over - the - counter medicati ons include aspirin, ibuprofen, naproxen sodium as well as combination medications co n- taining acetaminophen, aspirin and caffeine in appropriate doses. Prescription medications are available in several forms — tablets, inject ions as we ll as nasal sprays . The goal of treatment is to intervene as early as possible while the pain is still mild. Use of daily prophylactic medications may be necessary in those individuals who p resent with frequent headaches — usually more than ten day s per month. Unlike migraine headaches, tension hea d- aches tend to be steady and bilateral, with only moderate discomfort. Interestingly, they do not develop at night. Typically, stress and sleep disru p- tion are common triggers. Physical activity can d e- creas e their intensity. Scalp tenderness as well as sensitivity of the neck is commonly seen. Trea t- ments using aspirin, acetaminophen, ibuprofen, or naproxen sodium are all helpful. Caffeine co m- pounded with some of these products increases the efficacy of the t reatment. Incorporation of preve n- tive measures is easier said than done. Relaxation and stress management top the list. This has only been a very brief overview of the most common primary headache. Hea da ches should be taken seriously and discussed with you r physician , as many treatment options are avail a- ble. A headache that seems to be the worst and most severe you have had in y our life requires an emergency room consultation. As stated earlier , a headache is a sym p- tom. Consider other possible causes of hea d- aches — eye strain, sinus issues, use of pins pulling on the hair strands , as well as menstrual issues. Speak with your physician to address these pro b- lem s. Current targeted treatment choices provide just what you need and do not add more stress, which can lead to you know what — another hea d- ache. Просимо надсилати ваші матеріяли, питання та про позиції або по - українськи, або по - англійськи на адресу: unwlaourlife @ gmail . com
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