Tag Archives: Migraine

Straight, No Chaser: When Your Headache is Life-Threatening

Health Prevention, Neurology, , , , , , , , , , , , , ,

Brain-Aneurysm-Prognosis-Factors

All headaches are not created equal. Earlier we discussed migraines, but there’s a lot more to headaches than those. In fact, when you come to an emergency room with a history of migraines and tell us you’re having a migraine, we aren’t thinking about migraines first. The ER is all about the life-threats.

The lead picture suggests items to avoid if you’d like to improve your prognosis for headaches in general and especially certain ones like brain aneurysms. In other words, alcohol, cocaine and cigarettes increase  your risk for life-threatening causes of headaches.

Secondary headaches are those related to some other illness or condition that produces headaches as a symptom. These are much more common causes of headaches than migraines. They’re even more important because they could represent life-threatening conditions. So we’ll put aside the headaches caused by things like panic attacks and hyperventilation, influenza, dental pain, sinusitis, ear infections, eye strain, dehydration, hangovers, hunger and “brain-freeze.” (Yes, “ice-cream headaches” are a real thing!) Today we’ll point you to some conditions about which you should be concerned. (I’m intentionally leaving out especially uncommon ones and otherwise esoteric conditions. I wouldn’t want to encourage any hypochondriacs out there.)

  • AVM (arteriovenous malformation): an abnormal formation of blood vessels inside your brain
  • Concussions and post-concussive syndrome
  • Brain aneurysm: a ballooning of one of your brain’s arteries that can steal blood away from needed areas

unruptured-aneurysm

  • Brain tumor
  • Carbon monoxide poisoning: from breathing exhaust fumes
  • Encephalitis/Meningitis: inflammation and/or infection of different components of your brain
  • Subarachnoid and other intracranial hemorrhage: bleeding inside various parts of the brain

Aneurysmal_Subarachnoid_Hemorrhage-1

  • Stroke
  • Temporal arteritis: inflammation of an important forehead artery with potentially devastating consequences to your sight

Given that I’ve blogged on several of these already (you can always enter the term in the search box on the right for more details), I’m going to focus on the symptoms that may suggest your headache is different enough to get evaluated for a possible life-threat.
Consider this a “headache plus this symptom = go to the emergency room” list.

  • Altered mental status
  • Confusion
  • Difficulty standing or walking (different from baseline)
  • Fainting after a headache
  • High fever, greater than 102 F to 104 F (39 C to 40 C)
  • Nausea or vomiting that’s not hangover related
  • Numbness, weakness or paralysis on one side of your body
  • Slurred speech
  • Stiff neck
  • Vision disturbances (blurred or inability to see)
  • Worse headache of your life

Unfortunately, defenses go down in (and when evaluating) those with a history of headaches. This places you at additional risk. Even if you have had headaches before, if you have new symptoms or something seems different about a new episode, the decision to get evaluated could save your life.
Feel free to ask any questions you may have on this topic.
Order your copy of Dr. Sterling’s new book Behind The Curtain: A Peek at Life from within the ER at jeffreysterlingbooks.com, iTunes, Amazon, Barnes and Nobles and wherever books are sold.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook @ SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
Copyright © 2016 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: Migraine Headaches Questions and Answers

Neurology, , , , ,

migraine-enhd-ar1

There are 30 million migraine sufferers in the U.S. alone.  Women are three times as likely to have them, but both sexes have to address the issues raised by them.  Here are some important facts regarding migraines and myths surrounding them, based on questions I’ve actually been asked.  And yes, regarding the lead picture, I refuse to say she’s lion.
Myth #1: I can’t help if I get migraines.  They’re hereditary, right?
There are a few things about being predisposed to having migraines I want you to know.

  • If you have one parent with migraines, there’s a 50% chance you’ll have them.
  • If both your parents have migraines, there’s a 75% chance you also will.
  • 4 of 5 migraine sufferers have a relative with migraines.

These facts represent a predisposition.  In order to have migraines, you must have triggers that will set off the migraine.  That’s a vital consideration in your effort to prevent, reduce and effectively treat your migraines.
headache
Myth #2: This is a woman’s disease.  They stress out more and are more emotional.  That’s why they get headaches.
It is true that there is a strong hormonal component to migraines, particularly regarding estrogen and progesterone.  In fact, the incidence of migraines between the sexes is pretty equal until puberty.  Migraines are increased during pre-menstruation, when hormone levels are high.  Menopause may ease migraines. All of this said, men still get migraines as well because of the presence of other triggers.  It certainly does not appear to be true that women suffer stress at a disproportionate rate sufficient to claim it as more of a trigger in women than in men.  Both sexes’ stress responses include release of substances that expands blood vessels, causing migraines.
Myth #3: My migraines won’t get any easier as I get older.
Along the same lines as Myth #2, diminished hormone production that accompanies aging may help explain how most migraine sufferers have less frequent and less intense migraines after age 40.  Because of hormonal fluctuations during perimenopause, this reduction may not be seen.

  • Most people who get migraines have fewer headaches, and their headaches aren’t as strong once they hit 40. However, this may not be the case for women going through perimenopause. If hormones are a trigger for a woman’s migraines, then she could have more headaches during the period around menopause.

migraine-black-female-300x168
Myth #4: Once I’m diagnosed with migraines, only narcotics will help.
First of all, trigger identification and prevention is vital.  Migraine trigger management and treatment is a topic unto itself, but I’d like to point out a few important considerations.

  • Think triggers first and last.  The list of triggers includes foods (think chocolate, alcohol, aged cheese and caffeine; results vary with the individual), cold, stress, smoking and certain medications.  Alterations in mealtimes, exercise and sleep patterns must be monitored as well, these tend to exacerbate migraines.  Migraine sufferers are advised to maintain a headache log to identify triggers as things occur.
  • A special comment about caffeine: It helps some people, but for others it’s a migraine trigger, particularly if you’re a heavy user.  If you don’t drink many caffeinated beverages, one may help if you’re having a less than severe migraine.  If you’re taking enough in to create a caffeine dependency, overnight withdrawal may be enough to trigger a morning migraine.

Patients must become their own experts on how and when you use different medications.

  • I hope you and your primary care physician have discussed and have you focusing on your abortive medications.  These medicines can stop progression of migraines if used early enough, lik at the first sign of a migraine.
  • Painkillers have consequences.  As tolerance to and dependence on narcotics develop, withdrawal symptoms become more prominent.  Rebound headaches are a major component of these symptoms.  That’s a vicious cycle that doesn’t have a happy ending.  It’s important to note that your health care professionals do appreciate there is a difference between being drug seeking and drug dependent.

migraine acute or chronic headache symptoms need for painkiller or prevention therapy
Myth #5: Migraines really don’t cause problems beyond the headaches, right?
Wrong.  If you have migraines, take special care to ensure you have a healthy heart and a low risk for strokes.  Refer to the Straight, No Chaser archives (or just type in the search engine to the right) for information on stroke recognition and heart attack recognition.  If you are female and have migraines with aura (certain warning symptoms that precede you migraine like nausea, dizziness, light sensitivity and seeing zig-zag lines), your heart attack risk climbs by over 90% and your stroke risk more than doubles (increases by up to 108%).  The presence of migraines without aura also raises the risk of heart attack and stroke but by lesser amounts.
The message is simple, but execution is key. Prevention is protection, and knowledge is power.  Check back; the next Straight, No Chaser addresses life threatening causes of headaches, and feel free to send questions and comments.  Take good care.
Feel free to ask any questions you may have on this topic.
Order your copy of Dr. Sterling’s new book Behind The Curtain: A Peek at Life from within the ER at jeffreysterlingbooks.com, iTunes, Amazon, Barnes and Nobles and wherever books are sold.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook @ SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
Copyright © 2016 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: When Your Headache is Life-Threatening

Health Prevention, Neurology, , , , , , , , , , , , ,

Brain-Aneurysm-Prognosis-Factors

All headaches are not created equal. Earlier we discussed migraines, but there’s a lot more to headaches than those. In fact, when you come to an emergency room with a history of migraines and tell us you’re having a migraine, we aren’t thinking about migraines first. The ER is all about the life-threats.

The lead picture suggests items to avoid if you’d like to improve your prognosis for headaches in general and especially certain ones like brain aneurysms. In other words, alcohol, cocaine and cigarettes increase  your risk for life-threatening causes of headaches.

Secondary headaches are those related to some other illness or condition that produces headaches as a symptom. These are much more common causes of headaches than migraines. They’re even more important because they could represent life-threatening conditions. So we’ll put aside the headaches caused by things like panic attacks and hyperventilation, influenza, dental pain, sinusitis, ear infections, eye strain, dehydration, hangovers, hunger and “brain-freeze.” (Yes, “ice-cream headaches” are a real thing!) Today we’ll point you to some conditions about which you should be concerned. (I’m intentionally leaving out especially uncommon ones and otherwise esoteric conditions. I wouldn’t want to encourage any hypochondriacs out there.)

  • AVM (arteriovenous malformation): an abnormal formation of blood vessels inside your brain
  • Concussions and post-concussive syndrome
  • Brain aneurysm: a ballooning of one of your brain’s arteries that can steal blood away from needed areas

unruptured-aneurysm

  • Brain tumor
  • Carbon monoxide poisoning: from breathing exhaust fumes
  • Encephalitis/Meningitis: inflammation and/or infection of different components of your brain
  • Subarachnoid and other intracranial hemorrhage: bleeding inside various parts of the brain

Aneurysmal_Subarachnoid_Hemorrhage-1

  • Stroke
  • Temporal arteritis: inflammation of an important forehead artery with potentially devastating consequences to your sight

Given that I’ve blogged on several of these already (you can always enter the term in the search box on the right for more details), I’m going to focus on the symptoms that may suggest your headache is different enough to get evaluated for a possible life-threat.
Consider this a “headache plus this symptom = go to the emergency room” list.

  • Altered mental status
  • Confusion
  • Difficulty standing or walking (different from baseline)
  • Fainting after a headache
  • High fever, greater than 102 F to 104 F (39 C to 40 C)
  • Nausea or vomiting that’s not hangover related
  • Numbness, weakness or paralysis on one side of your body
  • Slurred speech
  • Stiff neck
  • Vision disturbances (blurred or inability to see)
  • Worse headache of your life

Unfortunately, defenses go down in (and when evaluating) those with a history of headaches. This places you at additional risk. Even if you have had headaches before, if you have new symptoms or something seems different about a new episode, the decision to get evaluated could save your life.

Thanks for liking and following Straight, No Chaser! This public service provides a sample of 844-SMA-TALK and http://www.SterlingMedicalAdvice.com (SMA). Enjoy some of our favorite posts and frequently asked questions as well as a daily note explaining the benefits of SMA membership. Please share our page with your Friends on WordPress, on Facebook at SterlingMedicalAdvice.com and on Twitter at @asksterlingmd.

Copyright © 2014 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: Migraine Headaches Questions and Answers

Neurology, General Health and Wellness, , , ,

headache
There are 30 million migraine sufferers in the U.S. alone.  Women are three times as likely to have them, but both sexes have to address the issues raised by them.  Here are some important facts regarding migraines and myths surrounding them, based on questions I’ve actually been asked.  And yes, regarding the lead picture, I refuse to say she’s lion.
Myth #1: I can’t help if I get migraines.  They’re hereditary, right?
There are a few things about being predisposed to having migraines I want you to know.

  • If you have one parent with migraines, there’s a 50% chance you’ll have them.
  • If both your parents have migraines, there’s a 75% chance you also will.
  • 4 of 5 migraine sufferers have a relative with migraines.

These facts represent a predisposition.  In order to have migraines, you must have triggers that will set off the migraine.  That’s a vital consideration in your effort to prevent, reduce and effectively treat your migraines.
Myth #2: This is a woman’s disease.  They stress out more and are more emotional.  That’s why they get headaches.
It is true that there is a strong hormonal component to migraines, particularly regarding estrogen and progesterone.  In fact, the incidence of migraines between the sexes is pretty equal until puberty.  Migraines are increased during pre-menstruation, when hormone levels are high.  Menopause may ease migraines. All of this said, men still get migraines as well because of the presence of other triggers.  It certainly does not appear to be true that women suffer stress at a disproportionate rate sufficient to claim it as more of a trigger in women than in men.  Both sexes’ stress responses include release of substances that expands blood vessels, causing migraines.
Myth #3: My migraines won’t get any easier as I get older.
Along the same lines as Myth #2, diminished hormone production that accompanies aging may help explain how most migraine sufferers have less frequent and less intense migraines after age 40.  Because of hormonal fluctuations during perimenopause, this reduction may not be seen.

  • Most people who get migraines have fewer headaches, and their headaches aren’t as strong once they hit 40. However, this may not be the case for women going through perimenopause. If hormones are a trigger for a woman’s migraines, then she could have more headaches during the period around menopause.

Myth #4: Once I’m diagnosed with migraines, only narcotics will help.
First of all, trigger identification and prevention is vital.  Migraine trigger management and treatment is a topic unto itself, but I’d like to point out a few important considerations.

  • Think triggers first and last.  The list of triggers includes foods (think chocolate, alcohol, aged cheese and caffeine; results vary with the individual), cold, stress, smoking and certain medications.  Alterations in mealtimes, exercise and sleep patterns must be monitored as well, these tend to exacerbate migraines.  Migraine sufferers are advised to maintain a headache log to identify triggers as things occur.
  • A special comment about caffeine: It helps some people, but for others it’s a migraine trigger, particularly if you’re a heavy user.  If you don’t drink many caffeinated beverages, one may help if you’re having a less than severe migraine.  If you’re taking enough in to create a caffeine dependency, overnight withdrawal may be enough to trigger a morning migraine.

Patients must become their own experts on how and when you use different medications.

  • I hope you and your primary care physician have discussed and have you focusing on your abortive medications.  These medicines can stop progression of migraines if used early enough, lik at the first sign of a migraine.
  • Painkillers have consequences.  As tolerance to and dependence on narcotics develop, withdrawal symptoms become more prominent.  Rebound headaches are a major component of these symptoms.  That’s a vicious cycle that doesn’t have a happy ending.  It’s important to note that your health care professionals do appreciate there is a difference between being drug seeking and drug dependent.

Myth #5: Migraines really don’t cause problems beyond the headaches, right?
Wrong.  If you have migraines, take special care to ensure you have a healthy heart and a low risk for strokes.  Refer to the Straight, No Chaser archives (or just type in the search engine to the right) for information on stroke recognition and heart attack recognition.  If you are female and have migraines with aura (certain warning symptoms that precede you migraine like nausea, dizziness, light sensitivity and seeing zig-zag lines), your heart attack risk climbs by over 90% and your stroke risk more than doubles (increases by up to 108%).  The presence of migraines without aura also raises the risk of heart attack and stroke but by lesser amounts.
The message is simple, but execution is key. Prevention is protection, and knowledge is power.  Check back this afternoon for life threatening causes of headaches, and feel free to send questions and comments.  Take good care.

Thanks for liking and following Straight, No Chaser! This public service provides a sample of 844-SMA-TALK and http://www.SterlingMedicalAdvice.com (SMA). Enjoy some of our favorite posts and frequently asked questions as well as a daily note explaining the benefits of SMA membership. Please share our page with your Friends on WordPress, on Facebook at SterlingMedicalAdvice.com and on Twitter at @asksterlingmd.

Copyright © 2014 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: The Week In Review and Your Take Home Messages

The Week In Review, , , , , , ,

?????
Well, it was a busy week. Let’s look at what you may have missed.
On Sunday, we started with reviewing the important of National Minority Organ Donor Awareness Month. Over 56% of people on the national organ transplant waiting list are minorities. Consider checking in at http://organdonor.gov/becomingdonor/stateregistries.html.
On Monday, we reviewed human bites, which involve any lesion caused by your teeth that breaks the skin. These range from over aggressive hickeys to the Mike Tyson variety to lesions caused by punching someone in the teeth. We posted your FAQs separately here. My bottom line is you need to get evaluated every bite (that breaks the skin) every time.
On Tuesday, we reviewed alcohol intoxication, abuse and dependency and gave you the tools to assess that all important question: Do You Drink Too Much? We included a special Alcohol Facts and Fiction post for your consideration. In case you were wondering, that beer belly isn’t from your beer and is the least of your worries, either from the alcohol or the belly sides of the equation.
On Wednesday, we went Back to the Future in discussing low back pain and identified life-threatening conditions associated with low back pain. Remember to lift with your knees instead of your back, and beware of night-time back pain or loss of motion, sensation, bowel and/or bladder control. You probably heard the word Cauda Equina for the first time.
On Thursday, we discussed spider bites, focusing on the Black Widow and Brown Recluse spiders. Do you remember what a volcano lesion is? We also discussed shingles and answered a lot of questions about the chickenpox and shingles vaccines. The Straight, No Chaser recommendation is to get them (the vaccines, not the diseases)!
On Friday, we busted a few myths about migraine headaches and discussed life-threatening conditions associated with headaches. I want you to remember the association between migraines, heart attacks and strokes. Review the list of ‘headache plus’ symptoms to prompt you to get immediately evaluated.
On Saturday, we taught you how to fall. Do you remember what FOOSH stands for? We also reviewed the causes and treatment of ingrown toenails. Sometimes the simplest advice is the best. Stop biting your toenails!
Thanks to all of you who have filled out the Straight, No Chaser survey. I hope you’re seeing improvements to your satisfaction. The Week in Review post is a direct result of your feedback. We have 500 followers now in a month, which isn’t bad for a blog on a topic that can be a boring as health and medicine. Thanks for your support and continued feedback.
Jeffrey E. Sterling, MD

Straight, No Chaser: When That Headache is More Serious Than a Migraine

Health Prevention, , , , , , , , , ,

Brain-Aneurysm-Prognosis-Factors
All headaches are not created equal.  Earlier we discussed migraines, but there’s a lot more to headaches than those.  In fact, when you come to an emergency room with a history of migraines and tell us you’re having a migraine, we still aren’t thinking about migraines as the first consideration.  It’s all about the life-threats.  The lead picture suggests items to avoid if you’d like to improve your prognosis for headaches in general and especially certain ones like brain aneurysms.
Secondary headaches are those related to some other illness or condition that produces headaches as a symptom.  These are much more common causes of headaches than migraines.  They’re even more important because they could represent life-threatening conditions.  So we’ll put aside the headaches caused by things like panic attacks and hyperventilation, influenza, dental pain, sinusitis, ear infections, eye strain, dehydration, hangovers, hunger and ‘brain-freeze’ (Yes, ‘ice-cream headaches’ really are a thing!), and point you to some conditions about which you should be concerned (I’m intentionally leaving out many especially uncommon and otherwise esoteric conditions.  I wouldn’t want to encourage any hypochondriacs out there.).

 unruptured-aneurysm

  • Brain tumor
  • Carbon monoxide poisoning
  • Encephalitis/Meningitis: inflammation and/or infection of different components of your brain
  • Subarachnoid hemorrhage: and other intracranial hemorrhages

Aneurysmal_Subarachnoid_Hemorrhage-1

  • Stroke
  • Temporal arteritis: inflammation of an important forehead artery with potentially devastating consequences to your sight.

Given that I’ve blogged on several of these already (you can always enter the term in the search box on the right for more details), I’m going to focus on the symptoms you may have that may suggest your headache is different enough to get evaluated for a possible life-threat.

Consider this a ‘headache plus this symptom = go to the emergency room’ list

  • Altered mental status
  • Confusion
  • Difficulty standing or walking (different from baseline)
  • Fainting after a headache
  • High fever, greater than 102 F to 104 F (39 C to 40 C)
  • Nausea or vomiting that’s not hangover related
  • Numbness, weakness or paralysis on one side of your body
  • Slurred speech
  • Stiff neck
  • Vision disturbances (blurred or inability to see)

Straight No Chaser: Myth Busters Edition – Migraine Headaches Fact vs. Fiction

Health Prevention, Medical Treatment, , , , , , , , , , , , , , ,

headache

There are 30 million migraine sufferers in the U.S. alone.  Women are thrice as likely to have them, but both sexes have to address the issues raised by them.  Here are some important facts regarding migraines and myths surrounding them, based on questions I’ve actually been asked.  And yes, regarding the lead picture, I refuse to say she’s lion.

Myth #1: I can’t help if I get migraines.  They’re hereditary, right?

There are a few things about being predisposed to having migraines I want you to know.

  • If you have one parent with migraines, there’s a 50% chance you’ll have them.
  • If both your parents have migraines, there’s a 75% chance you also will.
  • 4 of 5 migraine sufferers have a relative with migraines.

These facts represent a predisposition.  In order to have migraines, you must have triggers that will set off the migraine.  That’s a vital consideration in your effort to prevent, reduce and effectively treat your migraines.

Myth #2: This is a woman’s disease.  They stress out more and are more emotional.  That’s why they get headaches.

It is true that there is a strong hormonal component to migraines, particularly regarding estrogen and progesterone.  In fact, the incidence of migraines between the sexes is pretty equal until puberty.  Migraines are increased during pre-menstruation, when hormone levels are high.  Menopause may ease migraines.    All of this said, men still get migraines as well because of the presence of other triggers.  It certainly does not appear to be true that women suffer stress at a disproportionate rate sufficient to claim it as more of a trigger in women than in men.  Both sexes’ stress responses include release of substances that expands blood vessels, causing migraines.

Myth #3: My migraines won’t get any easier as I get older.

Along the same lines as Myth #2, diminished hormone production that accompanies aging may help explain how most migraine sufferers have less frequent and less intense migraines after age 40.  Because of hormonal fluctuations during perimenopause, this reduction may not be seen.

  • Most people who get migraines have fewer headaches and their headaches aren’t as strong once they hit 40. However, this may not be the case for women going through perimenopause. If hormones are a trigger for a woman’s migraines, then she could have more headaches during the period around menopause.

Myth #4: Once I’m diagnosed with migraines, only narcotics will help.

First of all, trigger identification and prevention is vital.  Migraine trigger management and treatment is a topic unto itself, but I’d like to point out a few important considerations.

  • Think triggers first and last.  The list of triggers includes foods (think chocolate, alcohol, aged cheese and caffeine; results vary with the individual), cold, stress, smoking and certain medications.  Alterations in mealtimes, exercise and sleep patterns must be monitored as well, these tend to exacerbate migraines.  Migraine sufferers are advised to maintain a headache log to identify triggers as things occur.
  • A special comment about caffeine: It helps some people, but for others it’s a migraine trigger, particularly if you’re a heavy user.  If you don’t drink many caffeinated beverages, one may help if you’re having a less than severe migraine.  If you’re taking enough in to create a caffeine dependency, overnight withdrawal may be enough to trigger a morning migraine.

Patients must become their own experts on how and when you use different medications.

  • I hope you and your primary care physician have discussed and have you focusing on your abortive medications.  These medicines can stop further progression of migraines if used early enough at the first sign of a migraine.
  • Painkillers have consequences.  As tolerance to and dependence on narcotics develop, withdrawal symptoms become more prominent.  Rebound headaches are a major component of these symptoms.  That’s a vicious cycle that doesn’t have a happy ending.  It’s important to note that your health care professionals do appreciate there is a difference between being drug seeking and drug dependent.

Myth #5: Migraines really don’t cause problems beyond the headaches, right?

Wrong.  If you have migraines, take special care to ensure you have a healthy heart and a low risk for strokes.  Refer to the Straight, No Chaser archives (or just type in the search engine to the right) for information on stroke recognition and heart attack recognition.  If you’re a female and have migraines with aura (certain warning symptoms that precede you migraine like nausea, dizziness, light sensitivity, and seeing zig-zag lines), your heart attack risk climbs by over 90% and your stroke risk more than doubles (increases by up to 108%).  The presence of migraines without aura also raises the risk of heart attack and stroke but by lesser amounts.

As per routine at Straight, No Chaser, the message is simple, but execution is key. Prevention is protection, and knowledge is power.  Check back this afternoon for life threatening causes of headaches, and feel free to send questions and comments.  Take good care.