People who are at risk of migraine attack are as follows-

1. Those who suffer from eye strain due to continuous staring at work place or because of reading in bad light or sitting in wrong posture.

2. Extremes of heat due to overexposure in hot sun.

3. Extremes of sound due to being in constant high level traffic working in noisy environment.

4. Constant looking at bright and glaring lights.

5. People who are exposed to extremes of cold, those who move in highly cold weather and cold winds.

6. People who are more frequently exposed to polluted environments, like road and industrial pollution which releases large amount of carbon monoxide.

7. People who are exposed to chemical fumes and smells, volatile solvents in paints, paint removers, spot removers, gasoline and certain glues.

8. People who work with or being in the vicinity of poisonous chemicals like lead, isocyanides, organic reagents, pesticides, insecticides, etc.

9. Physical and mental stress.

10. Coloring agents, artificial sweeteners, preservatives in foods.

11. Hormonal fluctuations especially in women during menstrual period.

12. Certain foods which further intensifies the headache to them who are already suffering from headache.

One must try to take high fiber diet to avoid refined, process and canned foods. High fiber diet results in improved bowel movements and helps in evacuation of stools. Thus there will be no acid and gas formation in the digestive system. One should eat regular meals consisting of whole cereals, nuts, fruits, leafy vegetables, legumes and tubers. Milk and milk products should not be taken in excess quantity as too much of them can trigger migraine headaches. Citrus fruits and their juices remove toxins from the body. Removal of toxins often helps in controlling the headaches, but however do remember to avoid citrus fruits during migraine attacks.

Lists of foods to be avoided during migraine attack are as follows-

1. Chocolate and chocolate drinks

2. Cheese

3. Acid and citrus fruits (Lemon, Lime, orange, mosambi, malta, black grapes, grape fruits, plum, tomato, amla, imli)

4. Caffeine (coffee, soft drinks, tea)

5. Alcohol

6. Sugar

7. Salt

8. Fermented foods ( Soya sauce, idli, dosa, dokhlas, kulchas, bhaturas, naans, bread, doughnut )

9. Onion

10. Garlic

11. Ice or cold water

12. Vinegar

13. Nuts (special peanuts)

14. Smoked foods

15. Pickled foods

16. Chinese foods (as they contain monosodium glutamate)

17. Processed meat (as hot dogs, has salami and many other sausages)

18. Sodium nitrates and nitrites (used as coloring agents and preservatives in foods)

19. Certain fruits e.g. Bananas, papayas, avocado, pineapple

20. Some dried fruits such as raisin, dates, and prunes

21. Some diary products e.g. curd, buttermilk, sour cream

22. Smoking

23. Fats and fried foods

24. Some vegetables like spinach, broad beans, pumpkin, and peas

25. Eggs

26. Ice cream

27. Cookies and cakes made with yeast.

2. One of the common misconceptions is there is no cure for recurrent headaches and people should be habituated and have to learn to live with pain. The clarification for this is as follows- Headaches may not be cured forever. Most people can reduce pain and the disability of headaches through proper medical care., changes in the life styles and relaxation techniques.

3. One more misconception regarding recurrent headaches is people say they are not serious and they do not require any treatment. Remember most headaches do not cause death but adversely affect the quality of life. People need to manage frequent episodes of headaches to prevent strain on the family life and career opportunities.

4. Misconception- Only treatment of headache is taking medicines during pains.

    Clarification- Remember medicines can reduce the pain during an episode of headache but they always cannot prevent recurrent headaches. It is necessary to adopt healthy life-styles for managing the headaches.

5. Misconception- More frequent the headaches, there is more likely are the chances of serious brain disorders.

    Clarification- Totally untrue. In fact the opposite is true. The biggest threat is from sudden, severe and unusual headaches that are dangerous and indicate some serious diseases.

6. Misconception- All severe headaches are migraine

    Clarification- This is not always true. Migraine is a specific disease of the nervous system which produces one sided headache, and is accompanied by other symptoms also.

7. Misconception – High blood pressure is one of the common causes of headaches.

   Clarification- Untrue. Very few people with high blood pressure complain of recurrent headaches.

 At last I would just like to say that don’t jump to any conclusion for headache before consulting any doctor. Let me tell you all headaches are not very serious and does not cause brain disorder. Serious headaches are only 1% of all headaches and one should not worry about developing serious diseases such as brain tumor.

DIET- The most common headache problems which is related to diet is excessive intake of heavy and sour articles and greens, and drinking very cold water. Poor digestion of food results in putrefaction of food inside the intestines which results in headache.

LIFE-STYLE- Suppression of natural desires, inadequate sleep during nights, sleeping during the day time, alcohol intake, talking very loudly, exposure to cold weather.

Excess of sexual activity also causes headache.

ENVIRONMENT- Unpleasant smell, facing head-winds, and exposure to dust, smoke, cold and heat can also cause headache.

PSYCHOLOGICAL- Psychological stress, excessive worry or suppression of tears can lead to headache.

SEASON- Some people suffer from headache when there is abnormality in normal climate or season, or just before the onset of rains.

INJURY- Any injury to the head, irrespective of its severity, can cause headache.

SITE OF PAIN FOR VARIOUS CAUSES OF HEADACHE-

1. If the headache occurs in front of the head then it will be because of tension headache, toothach and sinusitis.

2. If the headache is on the sides of the head then it can be because of migraine, temporal arteriti and tension headache.

3. If the headache occurs all over the head or on the middle side then it will be because of tension headache or may be mostly tumor.

4. Headche on the back of the head or on the neck may also be because of tension headache, meningitis, subarachnoid, hemorrhage, cervical spondylosis and hypertension.

5. If the headache occurs around or above the eyes then it can be tension headache, migraine, cluster headache.

NEURALGIA-

Neuralgia is a painful physical or mental distress following the course of a nerve or its branches. Trigeminal is the 5th cranial nerve. One of the most common neuralgia is trigeminal neuralgia whose cause is unknown and it is the most painful of all the neuralgias. Recurring paroxysms of burning pain occur in one side of the face or in the ear and throat as a result of glossopharyngeal neuralgia. While the glossopharyngeal neuralgia can be cured by cutting the glossopharyngeal nerve but in the trigeminal neuralgia the trigeminal nerve inside the skull can be cut to provide permanent relief.

TEMPORAL ARTERITIS-

The region between and just above our eyes and ears is called the temple. The artery which runs across this region is called the temporal artery. Rarely an inflammation of the tissues inside this artery may occur and such condition is called temporal arteritis. It is not a common disease but if it is ignored and left untreated then it may even cause sudden and permanent blindness. It may result in stroke because of reduced blood supply to the brain.

Mostly the people above fifty years of age are commonly affected by temporal arteritis. If any elder person or someone who crossed fifty years of age complains of pain in the temple region then he should be investigated for temporal arteritis. Some times the temporal artery is promininent and painful to touch. ESR (Erythrocyte sedimentation rate) test is suggested by the doctors if the patient is suspected for temporal arteritis. If the ESR reading is more than 50 mm in first one hour then it indicates temporal arteritis. Biopsy is done for the confirmation of the temporal arteritis and it can be done by removing a small piece of the artery and examining under the microscope.

When it comes to treatment steroids are the only medicines recommended for treatment of temporal arteritis.

HEADACHE DUE TO TUBERCULOMA-

Any tumor, abscess or chronic inflammatory mass such as the tuberculoma causes increased pressure on the brain. It does not cause headaches in the early stages but very often headache is observed only after more serious complications such as paralysis. Tumors inside the skull put pressure on the brain at the site of its growth. It stops the outflow of the cerebrospinal fluid and therefore raises pressure within the skull and this rise in pressure causes dull persistent headaches.

HEADACHE DUE TO MENINGITIS-

Meninges are the loose coverings of the brain. Infection to these meninges is called as meningitis. Cerebrospinal fluid is the fluid in which the brain floats and this fluid supports the brain and protects it from shocks. As mentioned earlier meninges covers the brain and infection to meninges starts producing pus which is full of bacteria and if this pus enters the cerebrospinal fluid then it may directly come in contact with the brain and infect it very quickly. The most common symptoms of meningitis are fever, headache, stiffness of the neck and vomiting. The light becomes intolerable to the patient and soon patient becomes drowsy or unconscious. Anyone who is suffering from fever and stiff neck should be rushed to the hospital immediately. The faster the treatment the greater are the chances of recovery. But remember delayed treatments may often results in death.

Few nasal sinuses are present very close to the brain. Inflammation caused to any of these sinuses will lead to severe headache. This is because inflammation in the sinuses will bring the oxygen level down and this in turn leads to an increase in the carbon dioxide level in the system. This leads to congestion in the tissues of the brain making them starved for oxygen and thus results in headache. The pain caused is very severe especially in the early morning hours when the patient wakes up from sleep and generally improves during this day when an erect posture is maintained. Pain can be increased when the patient shakes his head or gets under strain. Such headaches can be more in sunlight and gradually decreases during evening hours when the sun sets. Sinusitis is initiated by colds and other respiratory infections which result in congestion of nose and respiratory tract.

HEADACHE DUE TO EYE STRAIN-

The small ciliary muscles control the shape of the lens of the eye within the eyeball. This helps us to focus our vision on any on particular object or thing. Prolonged contraction of these muscles can be a cause of headache due to eyestrain. Extra ocular muscles (muscles which control the movement of eye) may go into the tension, particularly when there is no balance between the movements of muscles on the two sides. This imbalance leads to blurred vision so that the head should be held in one position in order to focus the vision. This causes chronic contraction of the muscles of the neck leading to headache.
There are delicate tissues present within the eyes. If eyes are exposed to a very bright light this delicate tissues may be irritated and may cause headache which may last for about 24 to 48 hours. Further looking at the sun only for a few seconds may even burn the retina and cause a severe headache.

2. Train your body to evacuate (passing stools) twice a day every morning and evening. This will prevent the release of gases from the undigested food.

HEADACHE DUE TO HIGH BLOOD PRESSURE – Headache due to high blood pressure is mainly because of pressure within the arteries mainly in the smaller arteries specially in the brain. Headache due to blood pressure is mainly experienced at the back of head and it is more severe when the person wakes up in the morning.

The headache caused because of the contraction of the muscles of the neck is called tension headache. More than 70% of headaches are of these kind. One can identify the painful areas on the muscles of our neck by running our fingers on any one side of the neck.

Prolonged psychological tension, sitting in poor posture or in the same posture for a longer period of time often produce a spasm of muscles in the back of the neck and this muscle spasm produced draws the tissues over the surface of the cranium very tight, so that the pain is felt not even on the back of the neck but also but also over the top and front of the head. This pain is a steady and aching kind of pain usually with no nausea, vomiting or flashing lights. To avoid such kind of tension headaches one should try to avoid emotional stress and disturbance, and do neck stretching and rolling exercises whenever you happen to stand or sit in same posture for a longer time. Further contraction of the eye muscles, scalp muscles and facial muscles for a longer time can also produce tension headache.

ALCOHOLIC HEADACHE-

Large quantities of alcohol intake causes hangover leading to severe headache. Alcohol is toxic and the toxicity of alcohol directly irritates the meninges or coverings of the brain, thus causing pain the head. Alcohol intake also leads to dilation of the arteries of the brain and this inturn produces a pain like migraine. Naturally the best treatment of this type of headache is to avoid excessive use of alcohol. Further the patient is advised to take bed rest till the crisis is over.

2. HEADACHE DUE TO CAUSES INSIDE THE BRAIN-
a. Brain tumors
b. Bleeding in the space around the brain
c. High blood pressure.
These kinds of headaches will be discussed in the forthcoming posts hopefully.