แผนกปวดศีรษะ – Bangkok Hospital Ratchasima

Headache Clinics

Generally, headache does not have severe causes and can be relieved by itself. Once having headache, symptoms should be observed to find the causes that may affect recurrent such as location of headache, time, what make the symptom better or worse.
Types of Headache
- Headache from muscle tension
  - The tension headache is like being pressed, squeezed, or wrapped at both sides of head. It commonly starts from the occiput and refers to temples, neck, shoulder. There may be pressure pain at scalp. Pain usually lasts more than 30 minutes and is commonly found in patients who have stress, anger, and tiredness.
  - Migraine Headache usually causes pain on one side of the head. Patients may also have pain around their eyes, nausea and vomiting. The symptoms may be worse with bright lights or strong odors. Patients are unable to tolerate bright light or noise. In some cases, patients may have flickering light in vision or blurry vision. The pain usually lasts for hours or a day.
  - Cluster Headache is commonly found in male aged 20 – 40 years old. Pain occurs on one side of head or face, especially around one eye, with redness of the eye, tears, and nasal congestion. The symptoms usually arise after drinking alcohol, travelling, and being upland.
  - Sinus Headache is caused from sinus infection. Patients may have dull pain around forehead, around and behind their eyes, cheekbones, or nose bridge, as there is nasal infection and mucus cannot drain out. In some cases, patients may have pain while bending their head down or changing posture.
  - Headache caused by abnormalities in brain. The characteristic of this type of headache is pain will gradually increase to severe pain. This is caused by the abnormality in the brain that enlarges causing more pressure in head. The pain is deep down in the head and the patient may also have nervous system problems such as weak limbs, numbness on one side of the body, unable to speak clearly, difficulty swallowing, loss of hearing, vomiting, seizure, and loss of consciousness.
  - Headache from inflammation of jaw. Patients may have pain on one or both jaws. Sometimes, the symptoms may show while chewing or sleeping bruxism. When opening mouth or moving jaw, there may be clicking sound.

Headache Symptoms that Require Immediate Medical Attention!!

Sudden, severe headache
Persistent, gradually worsening headache
Headache with fever, stiff neck, or rapid progression
Sudden, very intense headache
Persistent headache in older adults that does not improve
Headache in those who have never had them before
Headache with nausea or vomiting
Headache that wakes you up from sleep
Headache that affects vision or is accompanied by other unusual symptoms

Examination and Treatment

The doctor will conduct a thorough assessment, performing general physical and neurological examinations. Additional examination is considered for further investigation to support the diagnosis. The additional examination includes a blood test and X-ray of skull to see sinuses and bone characteristics. CT scan and MRI are also considered to be performed which offers results in more detail. In some cases, doctors may consider giving contrast media. Apart from X-rays, other necessary examinations may be performed such as lumbar puncture, in the case suspected of having Meningitis or spinal hemorrhage, and EEG depending on patient’s condition. Therefore, patients who have headache should have consultation with neurologist to receive recommendation and appropriate treatment.

“If you have severe headaches or chronic headaches that do not improve, you should see a doctor at Neuroscience Center immediately as headache could be a sign of a serious disease.”