Clinical Considerations of Quality, Location, Duration and Time Course of Headache


Headaches are of variety of types and thus can be classified and categorised on the basis of Quality of headache, Location of the ache in head, duration and time course of the headache. Also important are the situations under which a headache starts, how it aggravates and how it would be relieved are the important points to consider when analysing and understanding an headache in a particular person at a particular time and situation.

Headaches are also known as Cephalic Pains. Cephalic is a derivation from Greek work Kephalo which means the top most part of the body i.e. the head.

Quality of pain as a tool for diagnosis in headaches

Pain in the head can vary from tight band like pain to dull, deep located pain aching and boring in nature. Sometimes pain can be throbbing and as if jabbing inside the brain sharp in quality. Some times pain can be as if from multiple points of pain – ice pick like pain. Migraine types of pains can be throbbing type with tightness of the near by muscles of the neck and the scalp.

Intensity of pain as a tool for diagnosis in headaches

Intensity of pain can range from mild pain to highly intense throbbing type of pains. Pain intensity carries high diagnostic value in Homoeopathic medicine therapy, Ayurvedic, Unani type of medicine therapy but as such has less importance in Modern Medicine type of medical practice. Pain intensity has high significance for the patient.

Some of the types of headache having high intensity of pains are Subarachnoid hemorrhages (Unwanted blood flow in between the three covers [meninges] of the brain), Cluster headache, Migraine.

Location of pain as a tool for diagnosis in headaches

The location of pain in the head carries high importance with the person suffering from headache also with the physician understanding the complaints of the patient. The location gives a fair idea of what the problem may be if at all, in the underlying tissues. The major areas of pain in the head are at specific locations such as the Frontal, the upper parts called as the Parietal, the sides known as the Sphenoid and the Temporal, the back side known as the Occipital and the neck.

Pain can also arise at in between the eyes above the nose – The Bregma.

Duration of pain as a tool for diagnosis in headaches

Duration of headache and the intensity of headaches are related with each other in terms of diagnosis. A high intense pain in the head with a thunder clap like sudden violent pain may call for ruptured weakened blood vessel carrying pure blood to the brain. Cluster headache is a recurring type of headache which peaks over three to five minutes cycle and the maximum level ranges up to forty five minutes and then the pain goes off.

In contrast to the cluster headache, the Migraine starts as a mild pain continuously over many hours, slowly increases in its intensity and can stay for hours and days together and then taper off after reaching a peak. Migraines are better by sleep.

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