When Is a Headache More Than Just a Headache?

What would cause a 34-year-old woman to waken with severe and throbbing head pain, nausea and dizziness?  A 9-year-old to have a headache lasting four months? Or an otherwise healthy 32-year-old woman to have severe headaches and seizures?

These are just some of the difficult cases of severe headache pain the DENT Neurological Institute sees every day.

Laszlo Mechtler, M.D., Director of DENT’s Headache Center and President elect of the American Society of Neuroimaging, says, “Most of the people we see have primary headache disorders, such as migraine and tension type headaches. A common medical complaint, they are experienced by 75% of the population with over 5% seeking medical aid. In fact, about 16% of emergency room (ER) visits are attributable to headache complaints.”

Mechtler explains, “Patients who are the most complex are those where headaches come from a secondary cause, which includes more than 316 life-threatening disorders and illnesses. They are the toughest cases, and neuroimaging studies are required to determine the underlying cause.” Some of the key symptoms or red flags that help clinicians determine if further studies are needed include:

·   First or worst headache, onset of headaches after age 50, following head trauma, or in someone with cancer or HIV

·   Chronic daily headaches unresponsive to treatment or headaches with increased frequency and severity

·   Headaches always on the same side, or following exertion, strain or positional changes

·   Headaches accompanied by fever, stiff neck, rash, atypical aura, abnormal neurological exam or seizures

Of adults with headache seen in the ER, only 16-20% have secondary headaches, as compared with 77% of children. Of these children 45% suffer from secondary headaches due to neurological causes. Red flags in children differ from adult warning signs and include:

·   Persistent headaches that last less than 6 months but don’t respond to treatment

·   Headaches that awaken the child from sleep or occur when awakening or with episodes of confusion or disorientation

·   Family and/or medical history of central nervous system involvement or abnormal neurological test results

DENT is home to the only Headache Center in Western New York where more than 17,000 patients are seen yearly. In fact, the only other centers within reasonable traveling distance are located in Cleveland, New York City and Philadelphia. Trained staff at the Center include physicians who are board certified in neurology, neuroimaging, and  neuro-oncology supported by physician assistants, nurse practitioners, psychiatrists, nurses and clinical research staff.  Research and education are ongoing, as are new treatments and medications unavailable anywhere else. An onsite infusion lab and Urgent Care Center assures that patients can be seen 24/7. Meanwhile, Dr. Mechtler says, “About 120,000 people in our region suffer from migraines, but only 15% receive treatment. To learn more about headaches visit www.headache-advisor.com.

WNY Resource:

DENT Headache Center
716-250-2000
www.dentinstitute.com