Unfortunately, headaches don't always match their textbook descriptions. For example, the symptoms of different types of headaches can occur together. Many people suffer from a hybrid of tension and migraine headaches, which can cause confusion because there isn't a definitive test for either type of headache. A headache produced by stress or tight muscles can also resemble one caused by an underlying disease. To exclude more serious causes, doctors sometimes recommend additional tests, possibly including a computed tomography (CT) scan or magnetic resonance imaging (MRI).
Giant-cell arteritis (GCA) is the consequence of inflammation of the blood vessels. This condition gets its name because many cells in the blood vessel wall fuse to form a cell that is about five to 10 times larger than a normal-sized one. Its first sign may be a severe, constant headache. Those afflicted describe it as a severe throbbing, burning sensation, most often at the temple on one side of the head. Tenderness at the temple or scalp is also common. Although it can affect anything from the largest vessel in the body, the aorta, to the smallest blood vessels in the skin, GCA nearly always affects the blood vessels of the head.
GCA is most common in people over age 60, particularly women. A headache may be its only sign, or there may be other symptoms, such as a low-grade fever, fatigue, loss of weight or appetite, or a tender scalp or temple. Chewing may cause aching in the jaw muscles.
The inflammation can progressively narrow the affected vessels, reducing blood flow. In severe cases, arteries become totally blocked. If this happens in the artery supplying the retina, it threatens the vision in that eye. If a cerebral artery is impaired, a stroke could result. However, when caught and treated early, GCA responds well to treatment.
A test of your blood's sedimentation rate can help rule out GCA. This simple blood test determines the rate at which your red blood cells settle to the bottom of a test tube. An elevated rate suggests there's inflammation in your body. But the only sure way to diagnose GCA is to remove a small sample of the blood vessel and examine it under a microscope. This is a minor, outpatient procedure. The presence of inflammation and very large cells confirms the diagnosis.
I scream, you scream, some of us scream after ice creamOne minute you're enjoying a delicious ice cream cone; the next, you have "brain freeze". Generally, the headache is immediate and lasts for under a minute. It's usually a sharp, steady pain felt in the center of the forehead, but it may also appear on one side. The cause of cold-stimulus headaches, or ice-cream headaches, remains largely a mystery. One theory is that the pain originates in the back of the throat, which is chilled by the ice cream, but is felt in the head. This is known as referred pain. Any cold food or drink can induce such headaches, but ice cream is the main culprit because it's very cold and is often swallowed quickly. This doesn't allow for the treat to be warmed slightly in the mouth before it contacts the back of the throat. To the delight of ice cream lovers, doctors don't prescribe abstinence for headache prevention. Instead, they suggest taking smaller bites and eating slowly, to give your mouth enough time to warm up the ice cream. |