- Upper Respiratory Tract Infection with Sinusitis.
- Overwork of acute anxiety.
- Enteric group of fevers.
- URTI with acute sinusitis should be diagnosed with headache associated with symptoms of nose block, nasal discharge or sneezing with or without associated sore throat and cough. In short, during common cold, if severe headache develops and persists, above diagnosis should be made. Nose drops, analgesics and antibiotics relieve the patient.
- Overwork or acute anxiety can cause headache. Two tablets of paracetamol with or without a tranquilizer would give relief.
- An enteric group of fevers has changed its clinical presentation in the last few years. A dull headache with fever is quite common and may be the only symptom. Many viral fevers can also cause headache, but there is usually associated bodyache.
There are two important but rare causes of acute headache. Usually both produce severe headaches.
- One is Meningitis which is also called brain fever. Patient presents with fever and severe headache with or without vomiting. Neck stiffness should be looked for. Even with slight suspicion, urgent consultation or hospitalization should be recommended, because if delayed, patient is definitely going to die. In severe endemic areas, cerebral malaria is a differential diagnosis. Even during an attack of vivax malaria, a patient can experience severe headache.
- The second important cause is the brain hemorrhage-subarachnoid hemorrhage, which usually presents in young or middle aged patients. In this type of brain hemorrhage, paralysis is rare and they usually present with sudden, severe bursting headache only. Again, neck stiffness is present. Fever is not prominent. Hospitalization or consultation must be asked for because the death rate is high in this condition.
Chronic Headache: it is usually is of a few weeks, months or years. The longer the duration of the headache, easier it is to diagnose it in general practice. Chronic Headache can be divided into two groups:
- Chronic Paroxysmal headache
- Chronic Persistent Headache
Chronic Paroxysmal headache is defined as headache, where there are periods of freedom from pain. Headache might come once a week or once a month. There are three causes of this type of headache:
- Trigeminal Neuralgia
- Cluster Headache
Migraine comes for no reason at all. Often these are early morning headaches, following a good night sleep and rest. They come often on weekends or holidays. There are many precipitating factors e.g. Walking in the sun, seeing a movie, anxiety, alcohol or empty stomach etc. Very often, the headache is not unilateral and may be anywhere in the head. The headache can become very severe too. Other types of Headache:
- Sinus Headaches
- Chronic Sinusitis
- Tension Headaches
Various other Causes:
- Cervical Spondylosis
- Dental causes like pain in teeth