A headache is pain in the head, face, or neck due to nerve fiber irritation in muscles, blood vessels, or meninges. It can be mild or severe, affecting daily activities.
Mnemonic: "H.E.A.D. = Headache is Episodic, Aching,
Disruptive"
TYPES OF HEADACHE
1. Primary Headaches (No Underlying Cause)
- Migraine – Pulsating, Unilateral, Associated with Nausea.
- Tension-Type Headache – Band-like, Tight, Stress-Related.
- Cluster Headache – Severe, Unilateral, Around the Eye.
2.Secondary Headaches (Underlying Cause Present)
- Head Trauma, Stroke, Tumor, Hypertension, Sinusitis, Meningitis, Eye Strain.
Mnemonic: "M.T.C. = Migraine, Tension, Cluster (Primary
Headaches)"
1. MIGRAINE
Migraine is a primary episodic headache with neurological,
gastrointestinal, and autonomic symptoms.
Types:
- Migraine Without Aura (Common Migraine) → 90% of Cases.
- Migraine With Aura (Classic Migraine) → Visual or Sensory Symptoms Before Pain.
Symptoms (P.U.N.C.H.)
- P – Pulsating Pain.
- U – Unilateral Location.
- N – Nausea/Vomiting.
- C – Chronic Episodes (4-72 hours).
- H – Hyper-Sensitivity (Photophobia, Phonophobia).
Mnemonic: "P.U.N.C.H. = Pulsating, Unilateral, Nausea,
Chronic, Hyper-Sensitivity"
2. TENSION-TYPE HEADACHE
A mild to moderate headache with a tight band-like sensation,
commonly due to stress or muscle tension.
Symptoms (T.E.N.S.E.)
- T – Tight, Pressing Sensation.
- E – Episodic or Chronic.
- N – No Nausea or Vomiting.
- S – Stress-Triggered.
- E – Even Pain (Bilateral).
Mnemonic: "T.E.N.S.E. = Tight, Episodic, No Nausea, Stress,
Even Pain"
3. CLUSTER HEADACHE
A severe unilateral headache, mostly around the eye, occurring in
clusters (multiple times a day for weeks).
Symptoms (C.L.U.S.T.E.R.)
- C – Cyclical (Occurs in Clusters).
- L – Lacrimation & Eye Redness.
- U – Unilateral & Severe.
- S – Short Duration (15-180 min).
- T – Triggered by Alcohol, Smoking.
- E – Eye Swelling, Ptosis.
- R – Restlessness.
Mnemonic: "C.L.U.S.T.E.R. = Cyclical, Lacrimation, Unilateral,
Severe, Triggered, Eye Symptoms, Restless"
4. SECONDARY HEADACHES
A. Hypertension Headache (H.T.N.)
- Occurs in the morning, throbbing pain.
- Worse with exertion.
Mnemonic: "H.T.N. = Hypertension Throbbing in the
Morning"
B. Meningitis Headache (M.E.N.I.N.G.)
- M – Meningeal Irritation.
- E – Extreme Neck Stiffness.
- N – Nausea & Vomiting.
- I – Intense Fever.
- N – Neurological Symptoms (Seizures, Confusion).
- G – Gradual Onset.
Mnemonic: "M.E.N.I.N.G. = Meningitis, Extreme Stiffness, Nausea,
Intense Fever, Neurological, Gradual"
C. Brain Tumor Headache
(T.U.M.O.R.)
- T – Throbbing, Worse in the Morning.
- U – Unilateral or Diffuse.
- M – Mental Changes, Seizures.
- O – Occurs with Vomiting.
- R – Raised ICP Symptoms (Papilledema).
Mnemonic: "T.U.M.O.R. = Throbbing, Unilateral, Mental Issues,
Occurs with Vomiting, Raised ICP"
DIAGNOSIS OF HEADACHE
- Clinical History & Examination
- CT/MRI (If Red Flags – Trauma, Seizures, Vision Loss).
- Lumbar Puncture (For Meningitis).
Mnemonic: "C.T.L. = Clinical, CT/MRI, Lumbar Puncture"
TREATMENT OF HEADACHES
1. MIGRAINE MANAGEMENT
Acute Treatment:
- Triptans (Sumatriptan) – First-Line Treatment.
- NSAIDs, Ergotamine, Anti-Emetics.
Prophylaxis:
- Beta Blockers (Propranolol), Anti-Seizure Drugs (Valproate, Topiramate).
Mnemonic: "T.N.E.B. = Triptans, NSAIDs, Ergot, Beta
Blockers"
2. TENSION HEADACHE MANAGEMENT
Acute Treatment:
- NSAIDs, Paracetamol.
Prophylaxis:
- Amitriptyline (TCA), Stress Management.
Mnemonic: "N.A. = NSAIDs, Amitriptyline"
3. CLUSTER HEADACHE MANAGEMENT
Acute Treatment:
- 100% Oxygen Therapy.
- Triptans (Sumatriptan SC).
Prophylaxis:
- Verapamil (First-Line).
Mnemonic: "O.T.V. = Oxygen, Triptan, Verapamil"
4. SECONDARY HEADACHE MANAGEMENT
- Hypertension → Antihypertensives.
- Meningitis → Antibiotics, Steroids.
- Brain Tumor → Surgery, Radiation.
Mnemonic: "H.M.B. = Hypertension, Meningitis, Brain
Tumor"
HOMOEOPATHIC MANAGEMENT OF
HEADACHES
- For Migraine:
- Sanguinaria, Natrum Mur, Belladonna, Glonoinum.
- For Tension-Type Headache:
- Gelsemium, Nux Vomica, Bryonia.
- For Cluster Headache:
- Spigelia, Cedron.
Mnemonic: "S.N.B.G. = Sanguinaria, Nat Mur, Belladonna,
Glonoinum (for Migraine)"
FINAL REVISION WITH MNEMONICS
- Definition = "H.E.A.D. = Headache is Episodic, Aching, Disruptive"
- Primary Headaches = "M.T.C." (Migraine, Tension, Cluster)
- Migraine = "P.U.N.C.H." (Pulsating, Unilateral, Nausea, Chronic, Hyper-Sensitivity)
- Tension Headache = "T.E.N.S.E." (Tight, Episodic, No Nausea, Stress, Even Pain)
- Cluster Headache = "C.L.U.S.T.E.R." (Cyclical, Lacrimation, Unilateral, Severe, Triggered, Eye Symptoms, Restless)
- Meningitis = "M.E.N.I.N.G." (Meningitis, Extreme Stiffness, Nausea, Intense Fever, Neurological, Gradual)
- Brain Tumor = "T.U.M.O.R." (Throbbing, Unilateral, Mental Issues, Occurs with Vomiting, Raised ICP)
- Treatment = "T.N.E.B." (Triptans, NSAIDs, Ergot, Beta Blockers for Migraine)
- Homeopathy = "S.N.B.G." (Sanguinaria, Nat Mur, Belladonna, Glonoinum for Migraine)
