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Headaches are common and disabling. The good news is that the vast majority of headaches are treatable and not associated with serious illness. Consultation with a specialist to review a patient's medical history and an exam to establish a diagnosis and begin appropriate treatment are essential to reducing the burden of headaches.
Headache Diagnosis and Testing
Headaches are divided into two major groups: primary headaches (e.g., migraine, tension and cluster) and secondary headaches (e.g., tumor, infection, hemorrhage, increased intracranial pressure and all other). Primary headaches are more common and considered "benign." Secondary headaches occur as a symptom of underlying disease.
Every headache evaluation must first and foremost determine if the headache is primary or secondary. A careful and detailed history and physical exam are of utmost importance. Often, additional testing such as imaging studies with CT scan or MRI and/or lab work is necessary. These studies can be obtained onsite at Lahey Clinic. Neuroimaging studies are reviewed by Lahey Clinic neuroradiologists.
Headache Treatment
Once an appropriate headache diagnosis is made, the patient can be educated about his or her problem, and a treatment plan can be established. Medication management, identification and avoidance of headache triggers, and behavioral management strategies all play important roles.
Medications classified as "triptans" (e.g., Amerge, Axert, Frova, Imitrex, Maxalt, Relpax and Zomig) have revolutionized the acute treatment of migraine headache. The list of effective, preventive headache medications is expanding as more clinical trials are being conducted. The ultimate goal is to reduce the frequency and severity of headaches. If underlying causes of headache exist, these must be accurately and quickly identified and treated.
