For two years, Emeka suffered the excruciating pain of cluster headaches. Night after night he paced the floor, the pain driving him to constant motion. He was only 48 years old when the clusters forced him to quit his job as a systems analyst. One year later, his headaches got controlled through the help of the medical staff of a specialist headache clinic. Physicians there applied the latest research findings on headache, and prescribed a combination of new drugs.

Florence was a victim of frequent migraine. The bouts of the headaches usually span two days. Nauseous and weak, she prefers staying in the dark until each attack is over. Today, although migraine still interferes with her life, she has fewer attacks and less severe headaches than before. A specialist prescribed an anti-migraine programme that included improved drug therapy, a new diet and relaxation training.

An avid reader, Peju couldn’t put down the new mystery thriller novel. After four hours of reading, she slumped in bed, she knew she had overdone it. Her tensed head and neck muscles felt as if they were being squeezed between two giant hands. But for Peju, the muscle-contraction headache and neck pain got relieved soon by a cold shower and analgesic.

A large percentage of the Nigerian population now experience chronic headaches. For at least half of these people, the problem is severe and sometimes disabling. It can also be costly: headache sufferers make millions of visits annually to doctors’ offices.

What hurts when you have a headache?
Several areas of the head can hurt, including a network of nerves which extends over the scalp and certain nerves in the face, mouth, and throat. Also sensitive to pain, because they contain delicate nerve fibers, are the muscles of the head and blood vessels found along the surface and at the base of the brain.
The bones of the skull and tissues of the brain itself, however, never hurt because they lack pain-sensitive nerve fibres.

The ends of these pain-sensitive nerves, can be stimulated by stress, muscular tension, dilated blood vessels, and other triggers of headache. Once stimulated, a nerve sends a message up the length of the nerve fibre to the nerve cells in the brain, signaling that a part of the body hurts. The message is determined by the location of the nerve ending. A person who suddenly realizes “My toe hurts,” is responding to nerve endings in the foot that have been stimulated by the stubbing of a toe.

A number of chemicals help transmit pain-related information to the brain. Some of these chemicals are natural painkilling proteins called endorphins, Greek for “the morphine within.” One theory suggests that people who suffer from severe headache and other types of chronic pain have lower levels of endorphins than people who are generally pain free.

When Should You See a Physician?
Not all headaches require medical attention. Some headaches result from missed meals or occasional muscle tension and are easily remedied. But some types of headache are signals of more serious disorders and call for prompt medical care. These include: 
•Sudden, severe headache

•Headache associated with convulsions

•Headache accompanied by confusion or loss of consciousness

•Headache following a blow on the head

•Headache associated with pain in the eye or ear

•Persistent headache in a person who was previously headache free

•Recurring headache in children

•Headache associated with fever

•Headache which interferes with normal life

A headache sufferer usually seeks help from a general practitioner. If the problem is not relieved by standard treatments, the patient may then be referred to a specialist—perhaps a neurologist. Additional referrals may be made to psychologists.

What Tests Are Used to Diagnose Headache?
Diagnosing a headache is like playing Twenty Questions. Experts agree that a detailed question-and-answer session with a patient can often produce enough information for a diagnosis. Many types of headaches have clear-cut symptoms which fall into an easily recognizable pattern.

Patients may be asked: How often do you have headaches? Where is the pain? How long do the headaches last? When did you first develop headaches? The patient’s sleep habits, family and work situations may also be probed.

Most specialists will also obtain a full medical history from the patient, inquiring about past head trauma or surgery and about the use of medications. A blood test may be ordered to screen for thyroid disease, anemia, or infections which might cause a headache. X-rays may be taken to rule out the possibility of a brain tumor or blood clot.

A test called an electroencephalogram (EEG) may be given to measure brain activity. EEG’s can indicate a malfunction in the brain, but they cannot usually pinpoint a problem that might be causing a headache. A physician may suggest that a patient with unusual headaches undergo a computed tomographic (CT) scan and/or magnetic resonance imaging (MRI). The CT scan produces images of the brain that show structures or variations in the density of different types of tissue. The scan enables the physician to distinguish, for example, between a bleeding blood vessel in the brain and a brain tumor, and is an important diagnostic tool in cases of headache associated with brain lesions or other serious disease. MRI uses magnetic fields and radio waves to produce an image that provides information about the structure and biochemistry of the brain.

“Not all headaches require medical attention. Some headaches result from missed meals or occasional muscle tension and are easily remedied.”