Headache - Diagnosis

The first step in diagnosing a headache is to find out whether it is related to some other medical problem. For example, people who have experienced a head injury (see head injury entry) may also have headaches. A doctor needs to find out whether the headache is a result of such a condition or is the problem itself.

If the headache is the sole problem, a doctor conducts a physical examination and takes a medical history. He or she may ask how often the headache occurs, where it is located, what factors seem to cause the headache, and what other symptoms may accompany it. The answers to these questions help the doctor classify the headache into one of the three categories listed above.

Nearly everyone has headaches from time to time. Some conditions, however, are warning signs that medical care is necessary. These signs include:

  • "Worst headache of my life." This complaint could mean that damage has occurred to a blood vessel in the brain. Immediate medical attention may be required.
  • Headache accompanied by a weakness on one side of the body, numbness, loss of vision, or problems with speaking. These symptoms are possible indications of a stroke.
  • Headaches that become worse over a period of six months, especially if they occur in the morning. This pattern may suggest the presence of a brain tumor.
  • Sudden onset (beginning) of a headache. The presence of a fever along with the headache may indicate a serious brain disorder known as meningitis ("brain fever," pronounced meh-nen-JI-tiss).

Aspirin is one of the oldest drugs known to humans. Ancient people discovered long ago that pain and fever could be controlled by chewing on the bark of the willow tree or by rubbing oil of wintergreen on a sore part of the body. Willow trees and wintergreen both contain a chemical known as salicylic (pronounced SAL-ih-SILL-ik) acid.

Of course, the ancients did not know the chemical composition of willows and wintergreen. It was not until the mid-1800s that chemists gained that knowledge. Then, they became excited about the possible uses of salicylic acid. They thought it might be able to cure many different kinds of diseases. They also believed that it could be used to preserve foods.

They were right about the second point, but wrong about the first. For a time, salicylic acid became popular as a food preservative. But it was soon replaced by other, more effective methods.

Although salicylic acid did not cure disease, it was effective in reducing fever and relieving pain. But it had one serious side effect: It usually upset the stomach. Eventually, researchers found a solution to this problem. They converted salicylic acid into another form, called sodium acetylsalicylate (pronounced uh-SEAT-el-suh-LIS-ih-late). Sodium acetylsalicylate also acts to reduce fever and relieve pain. But it is less harmful to the stomach.

In 1899, the German chemical company, Bayer AG, began making sodium acetylsalicylate commercially. They named the product aspirin. Today, aspirin is probably the most widely used drug in the world.

To diagnose conditions such as these, a doctor may use a variety of tests, such as a computed tomography (CT) scan or magnetic resonance imaging (MRI). A CT scan is a procedure by which X rays are directed at a patient's body from various angles and the set of photographs thus obtained assembled by a computer program. This procedure is sometimes called a computerized axial tomography (CAT) scan. An MRI is a technique for studying the structure of internal organs by using magnetic waves.

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