Today Consultant ENT Surgeon Dr. Mrs. Chandra Jayasuriya (MBBS (Colombo), D.L.O.M.S (Otolaryngology), FRCS (Edin) speaks about some very common issues related to headaches. Here she talks about common issues we face in our daily life and possible solutions / treatment for such issues and other related facts.
Q – What are the causes for headaches?
A – There are two different causes. The first cause is the pathologies occurring inside the skull (Intracranial) and the second reason is the pathologies occurring outside the skull (Extra cranial).
The Intracranial causes :- Contents within the skull are brain, blood vessels, membranes covering the brain (meninges) and cerebrospinal fluid (CSF) which cushions the brain in the skull. If the volume of any of the contents is increased, pressure inside the skull rises. This causes severe, intractable headache resistant to painkillers.
The patient may have disturbed sleep patterns and may awake due to pain. The patient may rise early in the morning with severe pain. Vomiting and fits may also occur. These symptoms will cause a doctor to suspect an intra cranial pathology.
A thorough examination of the nervous system (including examination of the eye with an ophthalmoscope) is required. Brain scans (CT and MRI) are necessary to confirm the diagnosis.
Intracranial infections leading to abscess formation infections can spread directly through skull fractures or indirectly from ears and nasal sinuses through meninges is another reason for headache.
Dr. Chandra Jayasuriya.
Intracranial bleeding due to head injury or spontaneous rupture of congenitally malformed blood vessels are another reason for headache.
Brain tumour leading to increased skull pressure (abnormal growth of nerve cells, meninges or blood vessels or hydrocephalus – increased cerebrospinal fluid (CSF) content within the skull also can cause headache.
Extra cranial causes :- Diseases of the teeth. teeth infections or eruption of the last molar may lead to severe headache. People should have a routine dental check up on a six to 12 month basis.
CSF is between the brain and the meninges (covering brain). Four brain cavities situated within the brain are also filled with CSF. CSF inside and outside the brain gets continuously circulated. The intracranial pressure increases when circulation is blocked by tumours or trauma.
Q – What are the other causes for a headache ?
A – A person may not become aware of a gradual decrease of eyesight. Eye fatigue may erupt as a headache. In view of this, every patient with a headache should have his / her eyes examined. At around 40 years of age, the coordination of eye muscles becomes poor, resulting in poor sight (Presbiopia). There is also the risk of a beginning of cataracts and glaucoma (increased pressure inside the eyeball). It is therefore wise to consult an eye surgeon when one is around 40 years of age.
Sinusitis can cause headache. The causes for the sinuses getting blocked are allergy, catarrh, viral infection (cold), nasal blockage, administering nasal decongestants for a long time without medical supervision.
The symptoms of Sinusitis are runny nose, post-nasal drip causing excessive throat clearing, headache, bad smells emanating, nasal block, reduced sense of smell and bleeding from nose.
The treatments are antibiotics, painkillers, steam inhalation (in the initial period), surgical procedure at a later stage to remove stagnated phlegm. If any of the causes for sinus blockage are found, treatment should be given to eliminate the cause to stop a recurrence. Decayed teeth should be removed. to be continued…….
