Headaches
Headaches: At a Glance
What they are: Headaches are one of the most common neurological symptoms, ranging from mild to moderate tension pain to severe, persistent headaches that may signal an underlying condition.
Why they matter: While most are benign, some can indicate issues such as nerve irritation, vascular changes, or raised pressure in the brain, a common symptom of various medical conditions.
When to seek help: You should consult a specialist if they are persistent, worsening, or accompanied by symptoms such as visual disturbance, dizziness, or weakness.
Diagnosis: Often starts with a detailed clinical assessment and may include imaging such as MRI or CT scans if there are red flag symptoms.
Treatment options: Depend on the underlying cause and may include lifestyle changes, medication, nerve block injections, or surgical management if structural causes are identified.
Outlook: With accurate diagnosis and targeted treatment, most patients experience significant relief and improvement in quality of life.
Understanding Headaches
Headaches are one of the most frequent reasons patients seek neurological or neurosurgical assessment. They can arise from muscle tension, vascular changes, nerve inflammation, or structural issues within the brain or spine.
For many, they are triggered by stress, posture, dehydration, or sleep disturbance, but in some cases, they may be linked to conditions such as migraines, tension-type headache, or raised intracranial pressure.
A small proportion of headaches are secondary, caused by an underlying condition such as a brain tumour, vascular abnormality (like an aneurysm or AVM), or spinal cerebrospinal fluid (CSF) leak.
Types of Headaches
Where your headache occurs can often give clues about its cause. While every patient’s experience is different, certain patterns are common:
-
These are not caused by another medical condition and include:
Tension-type headaches: The most common type, often described as a dull, pressure-like headache pain around the forehead, scalp, or neck, usually related to stress or muscle tension.
Migraines: Typically one-sided and throbbing, often accompanied by nausea, sensitivity to light, and visual disturbances (aura).
Cluster headaches: Intense, one-sided headaches occurring in cycles or “clusters,” often around the eye.
-
These result from an underlying medical condition and require further investigation. Common causes include vascular abnormalities, raised intracranial pressure, or infection.
Understanding the types of headaches is essential in determining whether imaging or specialist assessment is needed.
When to Seek Specialist Advice
You should book a specialist consultation if you experience a constant headache, they are worsening, or occur several times a week.
Other red flag symptoms include:
Headaches that wake you from sleep
Head pain accompanied by visual changes, weakness, or numbness
A sudden severe headache (“thunderclap” headache)
Headaches associated with nausea, vomiting, or loss of balance
New or different headaches after age 40
Early assessment by a neurosurgeon can rule out serious causes and guide appropriate imaging or referral for treatment.
Your Diagnosis and Investigation
Diagnosis starts with a detailed review of your medical history, headache pattern, and associated symptoms
If structural or vascular causes are suspected, the following investigations may be recommended:
MRI or MRA scans to evaluate the brain and blood vessels
CT scans to detect bleeding or pressure changes
Cerebral angiography for vascular causes such as aneurysm
Lumbar puncture to assess cerebrospinal fluid pressure or infection
These investigations help differentiate between primary headaches (such as migraine or tension-type) and secondary headaches that may need surgical or medical intervention.
Treatment Options for Headaches
Treatment depends on the underlying cause and severity. Options may include:
Lifestyle Management
Stress reduction, hydration, improved sleep, relaxation techniques, and posture correction.
Medication
For migraine or tension-type headaches, including preventive and abortive treatments.
Nerve Block Injections
Used for occipital neuralgia or other nerve-related headaches.
Surgical Management
Rarely required, but may be indicated for structural or vascular causes (e.g. aneurysm, tumour, or CSF leak).
Monitoring
Regular review for patients with chronic or unexplained headaches.
Every patient’s plan is tailored individually. Where appropriate, Mr Kailaya-Vasan works in collaboration with neurologists and neuroradiologists to ensure a complete assessment and management pathway.
Living with Headaches
Living with chronic headaches can be physically and emotionally draining. Comprehensive care aims not only to relieve pain but also to identify and address headache triggers.
Many patients experience improvement after accurate diagnosis and personalised treatment, which may include preventive medications and lifestyle guidance to prevent headaches.
Ongoing monitoring and follow-up allow treatments to be refined over time, ensuring the best possible long-term outcome.
Book a consultation with Mr Ahilan Kailaya-Vasan
If you’re experiencing persistent or severe headaches, early assessment can provide reassurance and relief.
Appointments are available at top London hospitals, with remote options for international patients.
Seeking a second opinion?
If you have already received a diagnosis elsewhere, Mr Kailaya-Vasan can provide an independent review of your scans and medical notes, and explain the safest and most effective next steps.
FAQs about Headaches
-
They are often triggered by stress, tension, dehydration, or hormonal changes, but can sometimes signal underlying neurological or vascular issues. A specialist assessment helps identify the cause and best treatment.
-
Seek medical advice if they are persistent, severe, or different from your usual pattern, or if they are accompanied by other neurological symptoms.
-
MRI, CT, or other imaging may be used to exclude serious causes such as tumours, aneurysms, or CSF leaks.
-
Most can be well controlled once the underlying cause or trigger is identified.
-
Occasionally, they can signal raised pressure or vascular changes in the brain, which should be assessed by a specialist.
-
Daily headaches can result from stress, dehydration, posture, or medication overuse. If they’re new, worsening, or linked to other symptoms like vision changes or weakness, you should seek medical advice.
-
Morning headaches may be caused by poor sleep posture, teeth grinding, dehydration, or high blood pressure. Frequent episodes can also suggest raised pressure in the brain or sleep apnoea.
If you have any further questions, please get in touch.