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HEADACHE, TENSION OR VASCULAR

DESCRIPTION

Simple tension or vascular headaches include 3 types of pain: from muscle strain in the scalp, neck, and face; from constricted blood vessels in the head that cause pressure on blood-vessel walls; and from dilated blood vessels in the brain. Sensory nerves in the skin, scalp, blood vessels, and muscles of the head are involved.
Appropriate health care includes: self-care; physician's monitoring of general condition and medications, if headache persists or worsens despite self-care; biofeedback training or counseling for chronic headaches caused by stress.

SIGNS & SYMPTOMS
Any of the following:

  • Moderate pain in the front or back of the head, accompanied by tight muscles in the neck or scalp.
  • Constant pain over the temples, accompanied by the feeling that a vise is over the back of the head.
  • Throbbing pain all over the head.

    CAUSES
    Tension, producing strain on muscles of the neck, scalp, face, and jaw; sleep disturbances; excessive eating or drinking; physically exhausting work; anxiety or depression; eye strain, including sun glare; use of drugs or alcohol; low blood sugar; hormone changes during the menstrual cycle; allergic reactions; mal-aligned teeth.

    RISK FACTORS
    Stress, either mental or physical; environments that are noisy, stuffy, hot, poorly lit, or have irritating odors; exposure to or consumption of nitrites, sulfites, monosodium glutamate or other food additives.

    PREVENTING COMPLICATIONS OR RECURRENCE

    Instructions for your child: get enough sleep--an average of 8 hours for males and 7 hours for females; don't skip meals, especially breakfast; don't overeat; exercise regularly (See Appendix 19) to reduce tension and improve circulation; drink alcohol moderately -- no more than 1 or 2 drinks a day, if at all; don't smoke cigarettes, and avoid smoky environments; don't use mood-altering, mind-altering, stimulant, or sedative drugs; avoid foods that contain nitrites or other additives to which you are sensitive.

    BASIC INFORMATION

    MEDICAL TESTS

  • Your own observation of symptoms.
  • Medical history and physical exam by a doctor.
  • Special studies that may include ultrasonography, CAT or CT scan, MRI, and radionuclide scan (See Glossary for all).

    POSSIBLE COMPLICATIONS

    None expected for a simple headache.

    PROBABLE OUTCOME
    Most tension or vascular headaches can be relieved with simple treatment (see below).

    TREATMENT

    HOME CARE

    Urge your child to stop any activity and try to relax:
  • Massage the child's shoulders, neck, jaw, and scalp.
  • Give your child a hot bath.
  • Encourage the child to lie down. Place a warm or cold cloth, whichever feels better, over the aching area.

    MEDICATION
    Give your child acetaminophen or aspirin to relieve pain. Your child should try not to get dependent on stronger, prescription-type pain killers, sedatives, or tranquilizers.

    ACTIVITY
    Your child should rest in a quiet room.

    DIET & FLUIDS

  • Most children feel better if they don't eat, unless the headache is from low blood sugar.
  • Urge your child not to drink alcohol.

    OK TO GO TO SCHOOL?

    When appetite has returned and alertness, strength, and feeling of well-being will allow.

    CALL YOUR DOCTOR IF

    Your child has a headache and any of the following:

  • Fever of 101F (38.3C) or higher.
  • Recent head injury.
  • Drowsiness.
  • Nausea and vomiting.
  • Pain in one eye.
  • Blurred vision.
  • High blood pressure.
  • Pain and tenderness around the eyes and cheekbones that worsens when the child leans forward.
  • Vision disturbances and vomiting prior to the headache.
  • Persistent headache pain for longer than 24 hours without other symptoms.
  • Suspicion that a prescription or non-prescription drug caused the headache. ‡
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