May 23 2007
Seeking Medical Advice for Headaches
Diagnosis of nearly any medical condition is harder than it seems. For example, many people who believe they have sinusitis (an inflammation of the sinus cavities that produces headache pain), often actually have a mild migraine. According to one reliable study, 97% of the participants misdiagnosed their condition, in fact having migraines.
But you can improve the odds of getting a correct diagnosis from your physician by giving him or her all the assistance you can.
Headache Diary
First and foremost, for those who have frequent headaches, keeping a diary is a must. The diary should note when it began and ended, as accurately as possible. Note the location and type of pain as well as you can. Though pain is subjective, it’s helpful to make notes about the severity, too.
Knowing the degree, type and frequency of a headache is the first step to differentiating between, say, a migraine and a cluster headache, or an ordinary tension headache. Migraines produce a pulsating pain that strikes at odd moments, while cluster headaches tend to occur around the same time every day for weeks.
Make careful notes about diet, exercise and life-factors, too.
Changes in diet can lead to certain headaches. Chocolate, red wine, cheese and other foods and drinks are often triggers for those who are a sensitive. Excess exercise can often produce headaches, though how much is excessive will, of course, vary from person to person. Life-factors, such as moving to a new town, work or relationship stress and others can produce headaches.
When those factors lead to an ordinary tension headache that responds to aspirin or acetaminophen, then doesn’t reoccur, there’s little to do. But when the condition becomes more intense or long-lived, that diary is essential to providing physicians with needed clues for proper diagnosis.
Advanced Tools
There are literally hundreds of underlying medical conditions that can produce so-called ’secondary headaches’. That is a headache in which the head pain and its cause is not the primary factor. In ‘primary headaches’ the head pain is itself the medical condition.
No one, not even physicians, can always detect correctly at first which of these possible conditions is responsible. But they have the tools that can narrow them down. CT scans and MRI are two of the most common.
CT (Computer Tomography) scans use a series of directed x-rays that are combined by the computer to provide a 3-D ‘picture’ of the brain. MRI (Magnetic Resonance Imaging) does not use x-rays, but the electromagnetic activity of the brain itself, to map structures and conditions within the skull.
Both those have become outstanding diagnostic tools to determine the type of headache and any possible underlying neurological condition that might be producing it. In rare (but often obvious, once the tests are complete), cases a brain tumor or cancer is the underlying cause of headache.
Between these two sets of information - that gathered by the patient, and those used by the physician - diagnosis isn’t automatic or flawless. But the odds of correctly assessing any regular, intense or long-lived headache pain are greatly improved.

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