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DISORDERS

A headache is pain or discomfort felt in the region of the head and neck, however, there are more than 200 types of headache disorders. The most prevalent headache type for which patient seek medical help is a migraine. 


What is a headache?


A headache is pain or discomfort felt in the region of the head and neck. Headaches vary greatly in terms of how the pain is felt, the location, intensity, occurrence and accompanying symptoms. Interestingly, the brain doesn’t feel pain.

However, other parts of the head and neck area are pain sensitive and therefore responsible for headache occurrence:

  • Nerves that extend over the face, scalp, mouth, and throat
  • Muscles of the head, neck, and shoulders
  • Blood vessels found along the surface of the brain
  • In total there are over 200 types of headache disorders. 

How big is the problem?


Headaches are the most prevalent neurological disorders and among the most frequent symptoms seen in general practice. 
The average prevalence of migraine in the general population is 18% tension-type headache is more common than migraine, with a prevalence of about 52%. However, only frequent or chronic tension-type headaches are disabling. 

3% of the general population has a chronic daily headache, i.e., a headache ≥15 days per month. They are the most severely disabled headache and include both migraine and tension-type like headache.

Migraine

It is estimated that the prevalence of migraine is around 18%. However, with such common problem, we see that much of the information that people have is often incorrect.

This leads to false diagnosis and under treatment. Here are some of the information you need to know:

Symptoms

Migraine is a complex neurological disease that can have multiple different symptoms, of which a headache is the most important. However, to get a diagnosis of migraine you need to display at least some of them, including:

  • Nausea and vomiting
  • Sensitivity to light, sound, and odors
  • Difficulty concentrating
  • Vertigo, numbness or weakness in limbs

Migraine symptoms often begin in childhood, adolescence or early adulthood. Women are more affectee in all age groups, with a ratio of 3 to 1.

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Migraine usually lasts from four to 72 hours if untreated. The frequency of headaches varies from person to person - may be rare (once in a year) or strike several times a month.

Migraine is defined by presence of headache attack - significant throbbing pain or a pulsing sensation, usually on just one side of the head.  This can last for hours to days and can be so severe that is disabling.

Warning symptoms known as aura may occur before or with the headache in only about 25 % of patients. These can include flashes of light, blind spots, or tingling on one side of the face or in your arm or leg.

Migraines are not all the same, and in fact, several different types of migraine exist. Migraine with and migraine without aura are the two primary forms, but you also get sub types, which are: abdominal migraine, chronic migraine, and others.

In addition, the range of symptoms differs between patients, and even from one migraine attack to the next. So, we can argue that each migraine is different, it is not just a bad headache, and as such is not comparable between patients.

Statistically, 65% of patients who suffer from migraine are misdiagnosed, forcing them to live with ongoing pain and suffering for much longer than they should.

Any patient who displays some or all of the symptoms of migraine more than once should request an immediate referral to a specialist or contact the LF Headache Centre to schedule an appointment.

Nerve entrapment headache

In last ten years, LF headache research team found that some types of headache with different symptoms, including migraine-like, can be caused by sensory nerve entrapment in different areas of the face and neck – frontal, temporal, occipital. They have suggested the name – secondary headache attributed to peripheral nerve entrapment. 

Importantly, they discovered that these headaches can be alleviated in over 90 percent of cases, with new minimally invasive surgical treatment - popularly called "migraine surgery".

The procedure involves decompression of peripheral sensory nerve branches in different face and neck areas (frontal, temporal and occipital), which are the migraine trigger points.

Symptoms

In our practice, these patients suffer from:

  • Frequently occurring headache (> 15 days per month) 
  • Severe pain on visual analog score 6 – 10
  • Described as a localized pressure or tension
  • Often accompanied by photophobia and sometimes by nausea

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Causes

  • Frontal – supraorbital and supratrochlear nerve 
  • Temporal – auriculotemporal nerve
  • Neck - greater and lesser occipital nerve

Sinus Headache

Sinus headache is caused by disease inside the nasal sinuses and cavum – deviated septum in contact with mucosa, chronic sinusitis, etc. However, many people who assume they have pain from sinusitis, actually have migraines or tension headaches.

Symptoms

Signs and symptoms of sinus headaches — regardless of cause - may include:

  • Pain, pressure, and fullness in your cheeks, brow or forehead 
  • Worsening pain if you bend forward or lie down 
  • Stuffy nose 
  • Fatigue 
  • Achy feeling in your upper teeth

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Causes

The most common disease of the nasal sinuses and cavum that can cause headache are:

  • Deviated septum in contact with mucosa – contact point headache 
  • Chronic sinusitis
  • Concha bulosa – the anatomical variation of the middle turbinate
  • CHRONIC DAILY HEADACHE
  • TENSION HEADACHES
  • CLUSTER HEADACHES

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MEET THE TEAM

PETER JFM LOHUIS, MD PHD

BORIS FILIPOVIĆ, MD PHD

IVANA JURJEVIĆ, MD PHD

MARINA MILOŠEVIĆ, MD

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Poliklinika Lohuis Filipović 

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info@lf-mg.com

Tel: +385 1 2444 646


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