The monstER: The Headless Horseman’s Headless Aches (Episode 4)

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Headache Causes and Treatments

Headaches are fairly mysterious ailments, often arising without an immediately identifiable cause and exhibiting a wide range of variable symptoms. The ability to diagnose what kind of headache someone is suffering from, however, can help determine the proper course of treatment.

Tension Headaches

Tension headaches are the most common headaches, and are caused by contraction of muscles that surround the skull. Most often, the direct trigger cannot be specifically identified, but typically these headaches arise as a result of increased physical or emotional stress. Symptoms include a pressurized feeling around the head and neck, and pain localized in the eyebrow area. Tension headaches can be treated with over the counter medication like acetaminophen or ibuprofen, while massages and stress reducing practices like yoga serve as non-medicinal options.


Migraines are headaches caused by the enlargement of blood vessels around the brain. They are typically accompanied by nausea and sensitivity to light and sound, and are often signaled by an “aura,” characterized by flashing lights or a blind spot in one’s vision. Migraines are often hereditary, and can be triggered by increased stress, lack of sleep, or hormonal changes. They can be treated with over-the-counter NSAIDs or stronger medications called “triptans,” which constrict the enlarged blood vessels.

Cluster Headaches

Cluster headaches are the least common form of primary headache, affecting less than 1% of the population. These headaches (which can occur 1-2 times a day for up to 90 minutes at a time) may be triggered by irregular sleep patterns or certain medications, as well as smoking, alcohol, and even chocolate. They are often hereditary, are generally related to a genetic problem with the brain’s hypothalamus, and are indicated by runny nose and pain concentrated behind the eyes. Treatments include increased oxygen intake, injections of medications that constrict blood vessels (like Imitrex, also used to treat migraines), or the administration of a local anesthetic.

Secondary Headaches

Secondary headaches are not stand-alone problems, but are symptoms of a larger health issue. They are most often caused by concussions or untreated head and neck injuries, but may also be caused by withdrawal (even from substances like caffeine), excessive dehydration, or strokes. In more serious cases, secondary headaches may indicate brain tumors, meningitis, hemorrhages, or certain psychiatric disorders. Treatment of these diseases will typically serve as a remedy for the symptomatic headaches, so those suffering from headaches coupled with neck pain, severe fever, loss of consciousness, or a history of any serious ailment should immediately consult a physician.

Cranial Neuralgias

Cranial neuralgias are a unique category of headaches caused by nerve inflammation in the upper head and neck. These are characterized by severe facial pain around the eye and cheek, and while the direct cause is often unknown, these headaches are typically associated with multiple sclerosis or other muscle-related neurological disorders. They can be treated with anti-seizure medications and nerve stimulation.

Those treating themselves for headaches should be cautious not to over-treat themselves with too much medication, as this may cause liver problems (as in the case of acetaminophen overdose) or exacerbated ulcers (caused by aspirin). Those suffering from chronic or recurring headaches should seek the care of a physician, and should purchase a health insurance plan that will ensure coverage for their treatment.