When Should a Headache Be Taken Seriously?

Headache is a very common complaint in society. Most of the time, it may occur due to reasons such as stress, insomnia, hunger, dehydration, intense screen use, neck-shoulder muscle tension or migraine. However, some headaches should not be passed over only with painkillers; they should be evaluated neurologically.
As a neurology specialist, when evaluating headache, it is necessary to look not only at the pain itself, but also at all the systems that cause it. Because the brain, vascular system, nervous system, muscles, sleep and stress mechanism do not work independently from each other

Is every headache a migraine?

No. Not every headache is a migraine.
There may be migraine, tension-type headache, cluster headache, neck-related headaches, pains associated with sinusitis or headaches due to rarer but important causes.
Migraine is a neurological type of headache that usually comes in recurrent attacks, may have a throbbing character on one side of the head, and may be accompanied by nausea, light-sound sensitivity and worsening with movement.
However, all of these symptoms may not be seen in the same way in every patient.

Which symptoms are important in headache?

Some headaches require urgent evaluation. Especially headaches that start suddenly, are very severe or are described by the person as “the worst headache of my life” should be taken seriously.
If the following symptoms are present, medical help should be sought without delay:

• Sudden and very severe headache.
• Speech disorder, facial drooping, arm-leg weakness.
• Numbness, double vision, confusion.
• Fever, neck stiffness or seizure.
• Headache that starts after head trauma.
• Headache that starts newly after the age of 50.
• Headache that becomes increasingly frequent or changes character.
  
  

Why is it important to look at headache holistically?

Headache is often not caused by a single reason.
Insomnia, stress, hormonal changes, staying hungry for a long time, insufficient water consumption, teeth grinding, neck-shoulder muscle tension, intense screen use and frequent painkiller use may increase headache.
Therefore, in the evaluation, only the question “where is the pain?” is not enough.
When the pain started, how often it occurs, what triggers it, its relationship with sleep and stress, whether it increases during menstrual periods and the frequency of painkillers used should be considered together.

Is MRI necessary for every headache?

MRI is not necessary for every headache.
The need for imaging is determined according to the patient’s history, the characteristics of the pain, neurological examination findings and whether there are alarm symptoms. A typical migraine that has been continuing in a similar way for a long time and a headache that has newly started, worsens rapidly or is accompanied by neurological symptoms are not evaluated in the same way.

When should you consult a neurology specialist?

If your headache recurs frequently, affects your daily life, your painkiller use has increased, the form of the pain has changed or nausea, visual change, numbness, weakness or dizziness accompanies the headache, neurological evaluation is important.
In patients who apply with headache and migraine complaints in İzmir, the aim is not only to suppress the pain; it is to understand the underlying cause, triggers and its relationship with the person’s lifestyle.

Specialist Dr. Tuğba Korkmaz offers a personalized approach in the evaluation of nervous system diseases, especially headache and migraine, in the field of neurology. Considering that headache may not only be a symptom, but also a reflection of the underlying systemic balance, patients are evaluated with a holistic perspective.

Frequently Asked Questions

Which doctor should I see for a headache?
Headaches should be evaluated by a neurologist, especially if they occur frequently, affect daily life, increase the need for painkillers, or have a different character than previous headaches. If symptoms such as vision changes, numbness, weakness, dizziness, speech difficulties, or confusion accompany the headache, medical evaluation should not be delayed.

Does migraine show up on an MRI?
Migraine is usually not a condition that can be directly seen on an MRI. The diagnosis is generally made by evaluating the patient’s headache history, the characteristics of the pain, its duration, triggers, and neurological examination findings. MRI imaging may not be necessary for every migraine patient; it is mostly requested to rule out other causes or to perform a more detailed evaluation if warning signs are present.

Is it right to use painkillers every day?
Using painkillers frequently or every day for headaches may not be the right approach. In some people, frequent painkiller use can make headaches more frequent and chronic. Therefore, if the need for painkillers increases, the type of headache, triggers, and underlying causes should be evaluated neurologically instead of only trying to suppress the pain.

Is migraine psychological?
Migraine is not a psychological disorder; it is a neurological type of headache. However, stress, sleep irregularities, emotional strain, hunger, fatigue, hormonal changes, and environmental factors may trigger or increase migraine attacks. For this reason, migraine evaluation should include not only the severity of the pain but also lifestyle patterns, sleep quality, stress levels, and triggering factors.