Comprehensive Headache Care

Conditions We Treat

Migraine

These are severe recurring headaches that are generally accompanied by sensitivity to light and sound, nausea, and difficulty performing your usual activities. They tend to run in families and can be quite disabling. There are a number of useful treatments both medicinal and non-medicinal. In the chronicform of migraine, people experience 15 or more days of headache per month. Traditionally migraines were thought to occur on only one side of the head at a time but many people with migraine commonly experience pain on both sides of the head.

Migraine with aura

Some people (approximately 20%) with migraine can experience a host of symptoms just before the headache starts. These include visual changes, tingling or numbing sensations, speech difficulty, dizziness or even weakness in limbs. While these symptoms can be highly disturbing, they are considered harmless. On the other hand it is important to exclude other causes of these perceptual disturbances.

Posttraumatic headaches

After head injuries like concussion, people can experience troublesome headaches, sometimes very frequently. Other symptoms can include concentration and memory difficulties, sleep disturbances, personality changes and dizziness, among others. At times the headaches can have migraine-like features and in these cases, migraine treatments may work.

Tension type headaches

Tension type headaches represent a milder headache form of headache, but they can still be problematic especially if they are frequent. Usually tension type headaches are not accompanied by nausea and are treatable with over the counter medications.

Cluster headaches

These are probably the most intense headaches people can experience. The headaches are short but extremely intense and tend to occur around one eye. They occur in “cycles” lasting several weeks and these cycles can recur once or twice per year in many patients. Sufferers are usually men (although women can experience cluster headaches). Fortunately there are some very effective treatments which can actually interrupt a cluster headache cycle, and others which can quickly end an individual headache attack.

Hemicrania continua

This refers to a continuous headache limited to one side of the head which worsens and improves over the course of the day but never really stops. This headache is often missed or mistakenly diagnosed as migraine. That is unfortunate since there is effective treatment with a medication called indomethacin.

Low and high intracranial pressure headaches

Pressure in the brain tends not to change much over time as long as fluid and chemical balances remain stable. But on occasion things can lose that delicate balance and lead to high pressure in and around the brain, called “intracranial hypertension” or lower than normal pressure (“intracranial hypotension”). The headache of intracranial hypertension can be quite dangerous and even lead to vision loss. The
headache due to low intracranial pressure tends to be very sensitive to head position, with mild or no pain while lying down and much worse pain when sitting up or standing.

Medication overuse headaches

For mostly unknown reasons, people with migraines, and perhaps other headaches, tend to have more frequent and severe headaches when they take too much headache relieving medication. Even Tylenol® or other over-the-counter medications can lead to this problem. This does not generally happen if a person can limit ALL pain medications to 2 days per week. This is why we work so hard to limit the
frequency of our patients’ headaches to at most 2 per week.