I experience persistent headaches regularly. Could this be migraines? What causes this and how do I deal with it? Mercy

Dear Mercy

You have not specified how old you are and how long you have had these headaches, which part of the head is affected, what factor/factors cause aggravation of the headache and how is it relieved? The answers to these questions will help in finding the underlying cause of persistent headache.

In a young adult, persistent headache is usually due to eye strain and defects in vision. This occurs due to working for long hours in poorly illuminated rooms or using laptop computers, mobile phones for texting.

Migraine is caused due to mental stress and is another cause for severe, intense headache in young adults, mostly young women. The headache is mostly on one side of the head and is throbbing in character. There is commonly associated coloured halos in front of the eyes, nausea with or without vomiting. The headache is relieved by laying down in a cool, quiet room. Tension headache also occurs due to mental stress. It is dull to severe and is vague and generalised. Cluster headache occurs intermittently, more commonly in young men. One wakes up in the night due to intense headache, associated with a stuffed nose and red eyes. The exact cause of cluster headache is not known but as it mostly occurs around fall, it is presumed to be due to allergy or stress.

Chronic sinusitis is yet another common cause of persistent headache. In this, the air spaces of the skull are congested and inflamed, causing chronic headache, which is more common in the morning and is aggravated by looking down. It can occur at any age. Chronic ear infections, dental problems can also cause chronic headache.

High blood pressure can cause persistent headache in middle aged and elderly. Among elderly, eye problems like glaucoma, refractive errors can cause headache. Brain tumours are one of the sinister medical problems causing persistent headache. Here, the pain occurs over site of tumour, is more in the morning and may be associated with vomiting without nausea. Untreated, the pain will increase in severity. Infections of the brain or its coverings can cause persistent headache. Bacterial infections cause headache which is associated with fever, nausea, and vomiting. Fungal infections cause headache which is intermittent to begin with and then gradually becomes persistent.

Exact cause of headache can be known by clinical examination and investigations. The investigations include a complete blood count, X-ray and various scans of the skull. Treatment of any medical disorder causing headache, cures the headache. In case of stress related headaches, it is important to be stress free. Pain killers are used to reduce pain. Anxiolytic and tranquilizers are also useful.