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About headaches, and with me i have one of our neurologists from the neuroscience institute hello, my name is alexey shikuev, and i am one of the neurologists here at valley medical center. well, generally speaking, all the patients that we see in our clinic can be roughly divided with so-called ‘primary headache
Disorders’, primary medical condition causing the headache. and then we see patients with ‘secondary headache disorders,’ this is when the headache is caused by either an injury to the head, it could be trauma, it could be an infection, it could be a tumor or, many other medical conditions. you know,
You can have headache with a general infection, it’s not unfrequent to see headaches in flu and covid, certain medication can cause headaches as how often do people have headaches, and who suffers from them more? conditions are tension headache and migraine headache prevalence is probably around 25%, and there would be
About 40 million so, we see migraine headache is actually you know, two to three times more likely what are the newer options for prevention well, i think in the field of migraine treatment, we witnessed the real breakthrough over the last five years; a totally new class of medications just came up recently. in the past, we
Used to borrow a lot of medications from different fields, you know, we used to use some anti-seizure medications, some blood pressure medications, and some antidepressants to treat our migrant patients. these days, however, we have a class of medications that is specifically designed to treat migraines. they
Target a peptide called cgrp that we think is involved in the pathophysiology of a migraine. we currently have three different injectable medications, they can be injected just once a month, they have very favorable side effect profile, and usually are pretty well tolerated. this is usually done at an infusion
So those are used for the migraine prevention. now, we also have three new oral drugs, a slightly different mechanism of action, them can be used for migraine prevention, what are rebound or medication overuse well, certainly, medication overuse headache or, headache,” is something that we usually and
Have to use a lot of pain medications. so, usually when patients use headache medications for more than 10 to 15 days out of a month, then it’s not infrequent to see actual worsening of headaches instead of improvement. so, a medication overuse headache are typical over-the-counter pills, such as non-steroidal
Anti-inflammatory medications, be it ibuprofen, naproxen, aspirin or combination drugs such as excedrin; but even drugs as simple as tylenol, otherwise known as acetaminophen or paracetamol in certain countries. and also important to know that patients with chronic pains who opioid medications if you’re having more
Frequent headaches, should you keep a diary? to maintain a headache diary. and now with, you know, with modern technologies you can just use one of the applications on your phone. i frequency and duration of your headaches, when should you see a provider about your headaches? i think it’s appropriate to start with
Seeing your primary care doctor. they are usually pretty good with the diagnosing – diagnosing basic headaches, providing the basic workup and determine whether a patient needs to see a specialist or not. people usually come to see a headache specialist when there is a diagnostic uncertainty, a headache has atypical
Features, when the headache becomes resistant to treatment, or progress is getting worse despite the treatment. a headache can be a sign of a medical emergency, so it is important to know when to seek immediate medical attention. either call 9-1-1 or have one of your friends or family taking you to the closest emergency
Room. so, one scenario is a very rapid onset of a new excruciating headache, something that people call “the worst headache of the life.” the clue here is that the headache reaches its peak intensity in less than one minute, something that we call a “thunderclap headache,” and this can be a sign of
A serious medical condition like a brain bleed, ruptured aneurysm, a blood clot, or an arterial dissection. another scenario is when a headache is associated with the- what we call, “focal symptoms,” when you have a new weakness in one part of your body or the entire half of your body, either weakness or numbness,
Or acute onset vision loss, slurred speech or difficulty with speech, or inability to understand; that can be a sign of a stroke. and finally, there are situations when the headache is associated with the fever and it might come with the prominent neck rigidity thank you for answering our questions, dr. shikuev,
And for those of you watching, web link below to learn more.
Transcribed from video
DocTalk | Understanding Headaches | Alexey Shikuev, MD By Valley Medical Center
