Q. Whenever the weather changes, I get severe headaches. I have consulted a neurologist, allergist, family physician and chiropractor, and no one has come up with a treatment. Taking an antihistamine does seem to help, but even half of a child’s dose puts me to sleep for hours. I’m willing to try any prescription or alternative treatment you can suggest.
–S.W.
A. I don’t know whether one of your health care providers or you yourself came up with using antihistamines, but the fact that they work is an important clue to determining the cause of your headaches.
I’ll provide some background information on headaches in general and then focus on your specific situation.
Both chronic and recurring headaches can be painful and distressing. That’s bad enough, but sometimes headaches, which are more often symptoms or warning signs than disorders, can signal serious medical problems.
This is especially true if there’s a change in pattern or nature of the headaches, e.g., progression from rare to frequent or mild to severe.
Headaches are among the most common medical problems reported to doctors.
They are a symptom that has a broad range of possible causes. Identifying the cause can be difficult.
Medical history and a thorough examination are important. The intensity, quality and site of pain, especially the duration and presence of associated nerve-related symptoms, may provide clues to the underlying cause. In addition to the history and exam, it may be necessary to do MRI or CT scans, electroencephalograms and spinal-fluid analysis.
Major types of headaches are tension, spinal, migraine, cluster and sinus. These primary headache disorders are easily identifiable as different conditions, but they have much in common.
Tension headaches are the most common form, characterized by mild to moderate, intermittent, dull pain, often brought on by stress, fatigue or depression. They are caused by muscle tension in the neck, shoulders and head.
Problems in the neck, such as whiplash or abnormalities of the spine, can cause pain and tension in the neck, which in turn can cause headaches with many of the characteristics of tension headaches.
Migraine headaches occur most commonly in young women, are of moderate to severe intensity, and are often accompanied by nausea and increased sensitivity to light and sound.
Cluster headaches are defined as multiple, recurrent attacks of severe, usually unilateral (one side of the head) pain. They occur most often in middle-age men but are the least common type of headache.
Sinus headaches are due to increased pressure in the sinus cavities, which are located just above and below the eyes. They are associated with allergies and sinus infections, both of which cause the closing of holes that drain the sinus, resulting in pressure buildup.
Headaches are also associated with trauma, eye problems, sinus problems, brain tumors and infections, and hemorrhage in the brain.
Because you have problems during weather changes (in which the atmospheric pressure is changing) and because the major impact of antihistamines is to reduce swelling, my best guess is that your problem is with your sinuses.
You may have a problem with a chronic allergy or a chronic sinus infection that is making your sinuses prone to plugging up.
As you might suspect, it would be impossible for me to diagnose the cause of your headaches. I suggest that you return to a health professional to try to determine if your sinuses are the culprits.
It’s also important for people to understand the symptoms of stroke, one of which is headache, so that treatment will be started as early as possible.
In hemorrhagic stroke or intracerebral hemorrhage, a blood vessel in the brain bursts (hemorrhages), preventing normal blood flow and causing the pooling of blood in and around the brain.
Symptoms of intracerebral hemorrhage commonly include sudden onset of headache, nausea, vomiting, loss of equilibrium and loss of consciousness.
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Write to Allen Douma in care of Tribune Media Services, 435 N. Michigan Ave., Suite 1400, Chicago, IL 60611; or contact him at DRFamily@aol.com. This column is not intended to take the place of consultation with a health-care provider.
