Archive for the ‘Headaches and Migraines’ Category

There has been much attention given recently to the potentially serious injury to the brain from suffering a concussion.

For professional athletes, such as football players, the recovery goal has been to return to the game as soon as they are physically able.

But for schoolchildren — who are at significant risk of learning disabilities, emotional or behavioral changes and memory problems — the focus of recovery should be mental as well as physical rest.

From babies to high school students, children with concussions make nearly 144,000 visits to emergency rooms each year. A significant number of injuries also go unrecognized and are not reported. I personally see a number of concussion injuries in my practice each year.

Younger athletes may be at a greater risk of damage from a concussion, because their brains are not fully developed. When athletes take a hit to the head in football, are slammed by an elbow in soccer or fall from a bike or skateboard, the brain gets banged against the inner walls of their skulls, thus causing the injury commonly referred to as a concussion.

Common symptoms of a concussion are:

– Loss of consciousness, no matter how brief

– Headache

– Vomiting

– Memory loss or behavioral changes, especially confusion or feeling “foggy”

Children with the above symptoms, or any other symptoms that worry parents or adult guardians after a head injury, should prompt an immediate medical evaluation at a facility best suited for this, such as an urgent-care clinic or a hospital emergency room. The evaluating physician may order a CAT scan of the head, depending on how serious the signs and symptoms are.

It can no longer be acceptable for a head-injured athlete, young or old, to “shake it off” and get back into the game. Our young athletes must be instructed to immediately report any head injury.

Coaches and trainers have become more aware of the potential dangers, both short and long term, of traumatic brain injuries and are having the injured players seek immediate medical evaluation.

Especially dangerous is the “second-impact syndrome” when a player receives a second significant head injury within a short time after the first injury. This can lead to even more serious health consequences.

Those of us in the medical profession who deal with head injuries are using protocols to help return the young athlete to their routine activities. The focus of recovery is rest, both physical and mental. The injured athlete needs to be eased back into all routine activities, and a medical reevaluation should be performed before allowing a return to contact sports.

The bottom line is that head injuries in athletes need to be taken seriously because of both immediate and potential long-term consequences. Mental rest after the injury is just as important as physical rest.

Although this column focuses on sports-related head injuries, the principles I have discussed pertain to anyone with a head injury, no matter the age of the individual or the cause of the injury.

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Migraine headaches are common in our population, affecting about 17 percent of all women and 6 percent of men. These headaches are brought about by changes in a body chemical called serotonin, and high levels of it can cause blood vessels to shrink. The headaches are caused by low serotonin levels, which dilate blood vessels.

There are typically two types of migraines. One is associated with an aura that occurs before the headache and produces symptoms of bright flashing lights, blurry vision and unusual body sensations. Auras often last between 15 and 20 minutes and are usually (but not always) followed by a headache. The other type of migraine causes only the headache, without an aura.

The typical migraine headache can be quite severe and is often on only one side of the head, but is occasionally on both sides. The quality of pain can be either steady or throbbing. Other accompanying symptoms can include nausea, vomiting and sensitivity to light.

These headaches may occur only once or twice a year or as often as daily. Migraines can last from several hours to more than three days.

Certain foods can trigger migraines, such as:

  • aged cheese
  • chocolate
  • pickled foods
  • alcoholic beverages

Other migraine triggers include:

  • bright lights, loud noises
  • fatigue and stress
  • intense physical activity
  • menstrual periods
  • birth control pills

There are two types of migraine treatment. One type is the use of either over-the-counter pain medications such as ibuprofen (Advil), naproxen (Aleve) or acetaminophen (Tylenol), or with prescription migraine medication such as Imitrex.

Treatment should start as soon as the pain begins. A visit to the doctor may be necessary if these medications are not effective in relieving the pain.

The other type of treatment is using prescription medication to prevent the migraine attack. See your doctor about these various drugs and how they may help you.

Nontraditional therapies may also help:

  • acupuncture
  • massage
  • herbs — feverfew and butterbur
  • minerals — magnesium sulfate supplements
  • vitamins — riboflavin (vitamin B-2)

Symptoms of headaches more serious than migraines that require prompt medical attention are:

  • A severe, sudden headache like a “thunderclap.”
  • Headache with stiff neck, fever, rash or confusion.
  • Headache after a head injury.
  • New headache pain if you’re older than 50.

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