Headache Archive

Q. I have suffered from sinus headaches for years and have tried over-the-counter allergy medications without any improvement. Is there something else I can do?

A. Seasonal allergies can cause sinus congestion, sneezing, and a runny nose, but when you experience pain and pressure in your head it may be time to consider other causes. Headache is an unusual symptom for pure sinus problems, unless you also have an acute infection with yellow-green nasal discharge and fever. A daily headache over the eyes and cheeks, along with nasal congestion, is often labeled a "sinus headache," but it is much more likely to be a migraine headache.

Scientists are testing a new class of drugs to treat migraine headaches. The drugs would block (inhibit) a brain protein called CGRP that sends pain messages to the body.

People who have frequent migraines will quickly tell you that the pain can be excruciating. And for some sufferers, these headaches may also herald an increased vulnerability to small blood vessel damage in the brain and resulting strokes.

Approximately one in six adults in the United States reports having migraines. About a third of these people experience visual disturbances, known as aura, that precede the headache. While everyone with a history of migraines has a slightly elevated stroke risk, the likelihood double or triples in people with aura.

The pain reliever acetaminophen is safe when used correctly, but people can become very ill or die if they take too much.

You'll get relief faster by learning the symptoms of tension, migraine, and sinus headaches, as well as a stroke.

Different types of headaches respond to different treatments. So it's a good strategy to learn to identify the type of pain you're experiencing. "Knowing which type of headache you're dealing with will indicate which medications to use first. You'll know what to do about it, and you'll know what you're in for," says headache expert Dr. Paul Rizzoli, assistant professor of neurology at Harvard Medical School.

New Harvard research confirms some links, rejects others.

Two new studies from Harvard examine the possible associations between migraine headaches and other conditions. One study offers encouraging news: the headaches will not hurt thinking skills. Another study suggests a warning: the headaches, when accompanied by aura, may signal an increased risk of heart attacks and stroke. "After high blood pressure, migraine with aura was the second strongest single contributor to the risk of heart attacks and strokes," says study author Dr. Tobias Kurth, adjunct associate professor of epidemiology at the Harvard School of Public Health. "It was followed by diabetes, family history, smoking, and obesity."

Migraines and dementia

A migraine is a throbbing headache that begins mainly on one side of the head, often accompanied by nausea. It can last from four to 72 hours, and it can be made worse by loud noise and bright light. Sometimes people who get migraines see pulsating lights or black spots or have blurry, distorted vision shortly before the headache kicks in. That's called migraine with aura.

Suspected triggers for migraine with aura may not be as strong as some people think. Research suggests that a person who experiences migraines with aura can cross a trigger off the list if exposure to it for three months doesn't cause a problem.

Q. I have a long history of tension headaches and usually get relief by taking acetaminophen. Lately, the medication relieves the headache, but then the pain returns later in the day. Can acetaminophen lose its effectiveness, or could it be something else?

A. Any headache that is new or worsening should be evaluated by your doctor. He or she will try to diagnose the cause of your headache by reviewing your medical history and performing a physical examination.

Q. I have frequent migraine headaches. Does this increase my risk of memory loss or dementia?

A. This is a logical question, given that some studies have linked migraine headaches to an increased risk of symptomatic stroke as well as "silent" stroke. As we wrote in June, multiple "silent" or unnoticed strokes may lead to progressive memory loss, cognitive decline, and dementia. Your question is particularly important for women, since we are more likely to have migraine headaches than men, and we also have a higher prevalence of dementia.

Q. How long should I let a headache last before I see a doctor?

A. That's a hard question to answer without knowing a lot more. Some people have headaches frequently. Women are more likely to suffer from migraine headaches if another close relative (particularly a female relative) suffers from migraines. Many types of headaches, particularly migraine headaches, begin in childhood and afflict people for years.