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HeadWay, Issue #049 -- Secondary Headaches II
August 21, 2007

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In this month's issue:

Headache classification part 6 - Secondary Headaches II

What I wish you knew...

Say what?!  Comorbid

Headache classification part 6 - Secondary Headaches II

We're continuing our look at secondary headaches today.  These are the headaches that have an obvious, clear, cause, which is usually the target of the treatment (rather than simply trying to treat the headache).  We'll talk about 3 more today...

Headache attributed to non-vascular intracranial disorder

This category includes a whole host of disorders that may cause a headache.  For example, headaches that are a result of pressure inside the skull.  That could mean increased pressure, or even decreased pressure.

Also included in this category are inflammatory diseases, seizures, and Chiari Malformation type I.  As is normal with secondary headaches, usually the headache will go away after the disease or disorder is treated - in this case typically after 3 months.  In rare cases the headache seems to continue, but chronic post-intracranial disorder headache is still poorly understood.

Headache contributed to a substance or its withdrawal

Usually, this is a new headache that is closely related to a substance, even if it looks like a cluster, migraine, or tension-type headache.  However, if your doctor already knows about a previously existing headache, things can get tricky.

So what kinds of substances are we talking about here?  These might include:  alcohol, MSG (and other food components and additives - remember the hot dog headache?), cocaine, marijuana, caffeine (withdrawal) and opioids (withdrawal or overuse).  It could also include headaches related to overuse of medications such as ergotamines, triptans, and other painkillers and headache meds.

There are a few other causes, such as carbon monoxide, phosphodiesterase inhibitor drugs, histamine, Calcitonin gene related peptide, exogenous hormone, oestrogen, and various other medications and substances.

Two important notes.  First, substances can trigger symptoms you're already familiar with.  A migrainuer may get an attack due to alcohol or due to painkillers (remember the rebound headache?).  Also, after drinking a small amount of alcohol, a migraineur may have a migraine attack the next day.  Someone without migraine may need to drink a lot to end up with a headache.

Second, sometimes the headache is a delayed reaction.  The headache may start right away (when you take the substance), or may start after the substance has cleared from your blood.

Headache attributed to infection

The name says it all.  These infections include:  intracranial infections (bacterial meningitis, lymphocytic meningitis, encephalitis, brain abscess, subdural empyema), systemic infections (bacterial, viral, other) and HIV/AIDS.  It is also possible to have a chronic post infection headache - a post infection bacterial meningitis headache.

I'll leave it at that - these are the same as other secondary headaches:  Usually the headache clears up after a few weeks or months when the infection is treated or goes away.

For more on the headache classifications, you can read The International Classification of Headache Disorders here, thanks to the Migraine Aura Foundation.

What I wish you knew...

Every once in a while I put something up on the site that I wish everyone could read.  That's the way I feel about our most recent Community article.  I asked you to write what you wish your friends and family knew - about headaches or cluster or migraine.

The answers were brilliant.  And the collection of the best answers were very brilliant.  It's a long page, but if there was only one thing your family and friends would read, this would be a great choice!  Bring them to the computer, email them the link, or print it out and give it to them.  Here's the link:

The page is broken up into 5 things that you wish they knew, and the comments come from all over the world.  Here's a sampling:

I wish my husband would understand that I don't get migraines "on purpose" or simply to annoy him. They are out of my control. I don't enjoy missing work for migraines, and I don't need grief from him on top of that. I need support and understanding. It's not "just a headache." - Susan, USA

I would like for everyone to understand that the migraine attacks are so powerful and are making me unable to continue any kind of activity (work, eat, even sleep, etc). This affects basically my entire life (at work and at personal level), as I am not able to make any plans because I might end up having a bad migraine. - Oana, Romania

How alienated I feel when my family does not understand how migraine affects me, regarding both visible and emotion symptoms. This, in turn, affects their view and opinion of me. - Peggy, USA

Read the article now - What I wish you knew...

I'm hoping that I can give you many more opportunities to participate - for now, there is a new community question posted:  What would you recommend to people who are struggling to get their insurance company to pay for their treatment/medication?  Visit the page to give your answer!

Say what?!  Comorbid

You'll often hear about other disorders and conditions being cormorbid with migraine.  It's not as morbid as it sounds.  This simply means that there are other conditions that are likely to coexist with migraine.  For example, migraine and epilepsy are highly comorbid.  People with migraine are at least twice as likely to have epilepsy as the general population, and people with epilepsy are at least twice as likely to have migraine.  Back in 2005 I wrote a brief article about conditions that go along with migraine - Migraine's nasty relatives.

Have a comment?  A suggestion for a future topic?  Drop by the HeadWay MailRoom and use your password, nomoache!
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