Why Do Headaches Occur Frequently?

Headache is a symptom that manifests as a subjective experience of pain in the head. It can be a primary complaint or an independent condition, such as migraine, facial neuralgia, and temporal headache. Prompt and targeted treatment is essential for headache management. Gentle scalp massage can help, and it's advisable to avoid sleeping with wet hair to prevent headache. There are numerous potential causes of headache, and we will explore them in the following sections.

Headaches can be caused by infections, including intracranial infections or manifestations of systemic infections affecting the head. Vascular pathologies, such as cerebral hemorrhage and subarachnoid hemorrhage, can also lead to headache. Additionally, systemic diseases like hypertension can contribute to headache symptoms.

Headache is a subjective experience of pain in the head. It can be triggered by various factors, including external pathogenic influences, disturbances in qi and blood flow, and nutritional deficiencies affecting the brain and nervous system. Apart from diseases affecting the brain, skull injuries, and ocular, oral, and nasal pathologies, many systemic diseases can also cause headache. Headache, as a primary complaint, can also manifest as specific conditions such as migraine, facial neuralgia, and temporal headache. When the specific etiology of the headache is unclear, it may be temporarily diagnosed as "headache to be investigated" pending further evaluation and treatment.

1. Localization of headache can provide clues to the underlying pathology and disease type. For instance:

• Forehead pain often indicates Yangming meridian pathology, commonly associated with ocular and nasal diseases, as well as blood deficiency.
• Lateral headache suggests Shaoyang meridian pathology, often seen in ear diseases, migraine, and facial neuralgia.
• Posterior headache is often related to Taiyang meridian pathology, which can manifest in neck pain, vertigo, and brain tumors.
• Vertex pain typically indicates Jueyin meridian pathology, commonly associated with neurosis.
• Persistent and fixed headache locations can be indicative of brain tumors or intracranial abscesses.
• Generalized or diffuse headache can be associated with head trauma, mental exhaustion, and vertigo.

2. The duration, severity, and timing of headache can also aid in differential diagnosis:

• New onset headache is often associated with external pathogenic influences, such as colds and influenza.
• Chronic or recurrent headache is more commonly related to internal disorders, including various forms of debility.
• Sudden and severe headache can be seen in conditions like temporal headache, facial neuralgia, migraine, thunder headache, and hemorrhagic stroke.
• Headache that worsens in the afternoon or evening may suggest ocular disease, while morning or early daytime headache may be indicative of nasal pathologies.
• Progressive and severe headache often indicates malignancies or abscesses in the brain.

3. Differential diagnosis of headache can also be based on accompanying symptoms, physical examination, and laboratory tests:

• Headache accompanied by nausea, vomiting, fever, and elevated peripheral blood leukocyte and neutrophil counts may suggest pathogenic toxin invasion of the brain, such as influenza, spring fever, summer heatstroke, brain tuberculosis, toxic erythema, or intracranial abscesses.
• Headache without fever may be due to head trauma, internal injuries, temporal headache, or hemorrhagic stroke. Blood tests, cerebrospinal fluid examination, and cranial CT scans can assist in making a definitive diagnosis.
• Headache associated with dizziness, insomnia, and forgetfulness, often closely related to mental and emotional factors, with no positive findings on physical examination or laboratory tests, is commonly seen in conditions like neurasthenia and neurosis.
• Headache accompanied by elevated blood pressure is often indicative of vertigo.
• Posterior headache with associated dizziness, neck pain, numbness, and radiation to the shoulders, upper limbs, and neck is often suggestive of neck pain syndrome. Positive findings on X-ray and CT scans may be observed.
• Headache accompanied by night sweats and hot flashes is commonly seen in brain tuberculosis.
• Headache associated with dizziness, palpitations, pale complexion, decreased red blood cells, and hemoglobin levels may be diagnosed as blood deficiency.
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