Headaches are one of the most common symptoms, taking a variety of forms and with dozens of possible causes. While most headache triggers aren't serious -- stress, a hangover, a cold, falling or bumping into something, the "brain freeze" from ice cream -- others can be more concerning.
People suffering headaches often fear one of two things, says Michael Sellman, chief of neurology at Mercy Medical Center in Baltimore: brain tumor or cerebral aneurysm (a blood vessel bleeding in the brain). But these are relatively rare. "Headache is not the most common presenting symptom of a brain tumor," Sellman says, while an aneurysm typically causes an abrupt "thunderbolt headache" that makes it impossible to do anything else and that warrants immediate medical attention.
More often, though, headaches come on gradually and reveal something going on beyond the head. "Headache can frequently be a barometer or early warning sign of something wrong elsewhere in the body," Sellman says.
Possible headache cause #1: Medication overuse
Why: Many people suffer unnecessarily from pain caused by medication mismanagement of earlier headaches. "They start taking pain medication -- over the counter or prescription -- for episodic headaches or a straightforward tension headache, but it turns into the headache that never goes away," says Deborah Friedman, professor of neurology and neurotherapeutics at the University of Texas Southwestern Medical Center.
The problem is that the wrong medication or dosage was used in the first place -- or was overused -- and the person becomes reliant on the drug. The whole pain system gets out of whack and it hurts to come off the pain reliever, yet it also hurts to take it.
What to notice: A chronic dull headache that never goes away or worsens without pain medication. At your next doctor's appointment, ask your doctor about a medication review. If you're caring for an older adult, ask your loved one's doctor whether it's time to reevaluate drugs that have been taken for years.
Some people also have adverse reactions to new medications or changed dosages, so if you suddenly begin to experience headaches, it's worth noting whether you've had a recent medication change.
Possible headache cause #2: Giant cell arteritis
Why: Giant cell arteritis (GCA) is an inflammatory disease of blood vessels that usually strikes older adults. The vessels most affected are in the scalp and head, which helps explain the presence of headaches.
What to notice: A new, persistent, throbbing headache in someone 60 to 65 is the typical first symptom. For many people, the pain is centered at the temples or near the eyes. It's usually accompanied by flu-like symptoms or weight loss. The person may also experience loss of energy, sweating, jaw pain and weakness, blurred vision, and enlarged lymph nodes.
Women are more often affected than men, according to the American College of Rheumatology. Seeing a doctor is important because when the condition goes untreated, the person with it is at increased risk for vision loss and small strokes.
Possible headache cause #3: COPD
Why: Chronic obstructive pulmonary disease (COPD) is the combination of emphysema and chronic obstructive bronchitis, usually caused by lung damage due to smoking. Headache is one of the less notorious yet fairly common symptoms of COPD, compared with shortness of breath and worsening cough. More than 30 percent of COPD patients (mean age of 63) were found to suffer headaches in a 2003 study in Turkey.
What to notice:COPD headaches are worst when you wake up in the morning. That's because you're not breathing deeply enough at night, causing carbon dioxide to build. This dilates blood vessels in the brain, causing headaches. Someone who's increasingly awakening with such headaches and who is a smoker or who may have been exposed to lung irritants should be checked for lung disease.
Possible headache cause #4: Dehydration
Why: The first symptoms of dehydration is usually thirst; headache, fatigue, and weakness can follow. Changes in blood flow and electrolyte balance are thought to contribute to dehydration headaches.
What to notice: The headache may worsen when you bend over, walk, or move in any way. Dehydration can affect people of any age, though older adults and those with dementia are especially vulnerable because they lose the ability to "read" the body's thirst signals. Caregivers may hear a complaint of headache (or notice the person rubbing the head) without realizing the underlying dehydration. Look for signs of dehydration in someone with dementia, including feeling warm to the touch, cracked lips, increased confusion, dark urine that may smell bad, and a fast pulse.
Extra fluids are always a good idea, especially in hot weather or if you can't be sure how much the person with headache is drinking.
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