Headaches are a common problem to all of us. They are so common that at any one time in our lives, we will experience them. We will also come across others with similar experiences and compare notes – not only with regards to severity and duration, but also various remedies that might work, including herbal cures. When a remedy works, one would tell others about its efficiency and it can become viral on social media. Submersing both feet in ice cold water when you have a headache is an example of a viral remedy for headache.
However, this is not unique to Malaysians! This is just being human. When we have a problem, we want a solution.
There are many causes of headaches and I do not intend to discuss all of them because it will give us an even worse headache. I am also not going to talk about remedies that should go viral. Instead, I want to educate you, the readers, about red flags or when to seek help. We should be aware not only to help ourselves but also when to tell loved ones to seek medical advice when they confide in us about their headaches.
The first red flag is a long-standing headache with frequent recurrence that has been managed with over-the-counter medication. You might even have seen a medical practitioner, been investigated and found nothing. Then suddenly one day, the headache “beast” changed in nature and its behaviour! It has become severe and either lasted longer or shorter. You might have heard the term “thunderclap headache” – the worst headache ever, like thunder in your head. It could also feel like a punch in the face or a train hit your head.
If you experience a headache like that, please get help as soon as possible as it may be due to a burst blood vessel. It is an emergency condition that needs to be treated urgently. At least a CT scan of the head is needed.
The second red flag is a headache that lingers for years and you might have controlled it with familiar self remedies. However, the headache may have differed slightly. For example, a generalized constricting headache has become localized to a certain site or you have additional symptoms like nausea and vomiting. The headache may also stopped responding to usual remedies. It is advisable to get a reassessment as it may indicate something new. Any change in nature of a headache can mean something else is going on and further investigations are warranted.
The third red flag is if you have ever fainted after a headache. A fainting episode means the headache has changed course and there could be a sinister cause. I would advise that you do not sleep on this kind of headache. Contact your next of kin and get medical attention as soon as possible.
A headache is even more significant if you feel numbness over one limb or one half of the body. The sensation might not seem obvious to others, but you need to let someone know. A cerebral event like a stroke can present early this way. The longer you take to get medical attention, the worst it can become. These days, early diagnosis of stroke can be treated and permanent neurological deficits can be prevented.
That is part 1 of our discussion on headaches. Stay tuned for more!
Dr Rahmat is a neurosurgeon who believes strongly that knowledge empowers the public to make the right choices. Read more about him at The Team page.
[This article belongs to The Malaysian Medical Gazette. Any republication (online or offline) without written permission from The Malaysian Medical Gazette is prohibited.]