Janet Ogundepo
A Professor of Internal Medicine and Neurology at the University of Nigeria, Nsukka, Ikenna Onwuekwe, has urged individuals experiencing constant headaches after age 40 to seek medical intervention.
Onwuekwe stated that the onset of headache at this age could mean a vascular disease or tumour.
The don further advised persons with persistent headaches, regardless of age, to ensure they see qualified medical personnel.
He explained that although headaches, which are pain within and around the skull and structures such as the face, throat, ears, eyes and neck, were a common symptom and feature of human life, recurring headaches could indicate a tumour or other serious medical conditions.
“The brain which is the major content of the skull is insensitive to pain but structures around and in the brain such as the arteries, veins, muscles on the skull, eyeball, airways, scalp, bone, soft tissues, ligaments etc are susceptible and injury to these produce pain (headache),” Onwuekwe said.
The don further noted that headaches were the most common neurological disorder presenting in medical clinics globally.
According to the International Headache Society, the International Classification of Headache Disorders lists more than 250 types of headaches.
This number encompasses all the possible causes of headaches which are principally divided into primary and secondary headaches.
Data further shows that 42 -56 per cent of the global population is affected by headaches every year, averaging three billion persons.
The neurologist, in an exclusive interview with PUNCH Healthwise, noted that primary headaches were due to migraine, tension-type headaches and cluster headaches and had no identifiable cause.
He added that secondary headaches were linked to an identifiable organic cause such as, “uncontrolled arterial hypertension, stroke, degenerative cervical spine disease, infections, infestations and inflammations such as meningitis, otitis media, typhoid fever and malaria fever, eye conditions such as glaucoma and some refractive errors associated with periorbital muscle spasms, brain tumours and other causes of raised intracranial pressure, headache associated with coitus. This can be either simple or serious depending on the stage of sex in which it occurs.”
The expert clarified that while most headaches experienced by the public were not life-threatening and usually respond well to treatment, severe headaches should be recognised early and prompt medical attention sought, as they may signal an unchecked threat to life.
The neurologist said, “Such headaches are often recognised by looking out for features that Neurologists term SNOOP. S stands for systemic symptoms/signs and disease. Headache in the presence of fever, weight loss, cancer or reduced immunity etc needs to be checked out.
“N is for neurologic symptoms or signs. Headache in the presence of confusion, clumsiness, limb or face weakness, visual disturbance etc needs to be reviewed by the doctor. O is for headache of sudden onset. Headache that wakes you up at night. The worst headache of your life or a headache that is worsened when you bend or cough.
“The second O stands for onset after the age of 40 years. At this age, a headache may mean a vascular disease or tumour, etc and needs to be checked out.
“P stands for a change of headache pattern. When the headache is new and different, has changed pattern or quality or has increased in frequency or intensity.”
Continuing, Onwuekwe explained that while tension-type headaches were the most frequent and migraine the second most frequent headaches, females tend to have headaches more often than men.
“Migraine headache, which affects young females more, adversely affects the education of millions worldwide. My research studies here in Enugu, Nigeria have demonstrated that headaches remain a significant problem for our people.
“My team and I have found a 38.3 per cent prevalence for headache in community dwellers in Enugu which is dwarfed significantly by the 88.3 per cent prevalence we also found in medical students here in Enugu. These figures compare favourably with results from colleagues in other regions of the country. So we see age, occupation, culture and other variables playing out to explain differences in disease manifestation.
“So for most simple innocent headaches, common remedies most Nigerians take include rest, sleep and use of simple analgesics like oral paracetamol. These measures work for most people and where they don’t, sufferers tend to seek expert medical attention after exhausting all other alternatives, which include the use of herbal concoctions and resorting to spiritual healers.”
The internal medicine expert further noted that strokes and brain tumours could be underlying causes of headaches that could produce significant illness, loss of function, and lead to death.
He, however, noted that these headaches could be effectively treated or properly managed when detected early, leading to improved life.
The neurologist advised, “it is critical that when people have a headache, they should be watchful of its character and manifestation bearing in mind the SNOOP principle mentioned above. A stitch in time saves nine.”
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