Duration Health — Field Guide: Headache

Headache and Dizziness

Introduction

Headaches are a very common ailment. There are a few different types of headaches and many different causes of headaches. Some causes are benign and less worrisome; these include stress or anxiety, muscle tension, dehydration, alcohol hangover, caffeine withdrawal, prolonged eye strain or squinting. Some causes are more serious and require immediate evaluation and treatment including altitude sickness, high fever, carbon monoxide poisoning, stroke, tumor, meningitis and other severe infections.

The most common type of headache is called a tension headache. These headaches are usually described as tightness or ache, located on both sides of the head and more commonly felt in the forehead, back of head and neck. Another kind of headache is called a migraine headache, which is often described as pounding or pulsating, commonly located on one side of the head (although sometimes both sides) and can be associated with nausea, vomiting, and light and noise sensitivity.

Dizziness is a notoriously difficult ailment to treat, because it has so many causes. Some causes of dizziness are benign (not dangerous) while some are very dangerous, and it can be difficult to distinguish between the two, even for experienced practitioners. Dizziness with a perception of movement is called vertigo and may be caused by an inner ear problem, a problem in the brain such as stroke (an emergency), or some other cause.

Treatment

Treatment for headaches depends on the type and cause of the headaches. For tension headaches, we recommend ibuprofen or acetaminophen to help relieve the pain. For migraine headaches, ibuprofen or acetaminophen in conjunction with a caffeinated beverage may improve symptoms. For headaches related to dehydration, it is important to hydrate, and oral fluids such as oral rehydration solution can help with this. If you are experiencing headaches that could be related to altitude sickness, it is important that you stop ascending and if possible, move to a lower elevation.

When To Worry

Seek immediate medical care if you have any of the following:

  • headache that is the worst of your life and/or that came on suddenly or like a “thunderclap”
  • headache associated with weakness or paralysis on one side of your body, slurred speech or difficulty finding words
  • headache associated with fever and neck pain/stiffness
  • headache with vomiting that does not stop
  • seizures or convulsions related to headaches

Quick Guide

If you have

  • headache that feels like a tight band around the head
  • no fever or vomiting

You may have

tension headache

Consider using

ibuprofen 600 mg every 6 hours as needed for pain OR

acetaminophen 1000 mg every 6-8 hours as needed for pain (do not exceed 3000 mg per day)

OR

Pediatrics

For children age 17 and under

ibuprofen 10 mg/kg every 6 hours as needed; maximum 400 mg per dose

acetaminophen 15 mg/kg every 6 hours as needed; maximum 500 mg per dose

See also: Pediatrics

If you have

  • throbbing headache on one side of your head
  • sensitivity to light or noise
  • nausea or vomiting

You may have

migraine headache

Consider using

ibuprofen 600 mg every 6 hours as needed for pain OR

acetaminophen 1000 mg every 6-8 hours as needed for pain (do not exceed 3000 mg per day)

You can try drinking a caffeinated beverage with these medicines to lessen symptoms of migraine headache

If you have

  • dizziness
  • nausea or vomiting

You may have

vertigo

Consider using

meclizine (generic for Dramamine® Non-Drowsy) 25 mg or 50 mg, every 24 hours

OR

scopolamine 1 mg patch behind ear 12 hours before anticipated exposure to motion, then every 3 days as needed

OR

dimenhyDRINATE (generic for Dramamine®) 50 mg every 4-6 hours

OR

Pediatrics

For children age 17 and under

scopolamine should not be used in children unless recommended by a physician

meclizine and dimenhyDRINATE may be used at adult doses for children who weigh more than 40 kg

See also: Pediatrics

If you have

  • very severe headache
  • fever
  • headache associated with nausea or vomiting
  • headache associated with neck pain/stiffness
  • confusion
  • severe or persistent dizziness
  • severe eye pain or visual changes
  • passing out (fainting)
  • headache that is the worst of your life
  • weakness or paralysis on one side of your body
  • slurred speech or difficulty finding words

You may have

stroke, meningitis, high altitude cerebral edema (HACE), bleeding in the brain, acute glaucoma, or other life-threatening cause of headache

You should

seek emergency medical care

Reference

Ibuprofen (generic for Motrin, generic for Advil) is a pain reliever and the most commonly used non-steroidal anti-inflammatory drug (NSAID). Ibuprofen is used to treat pain.

GeneralMedication

Acetaminophen (generic for Tylenol) is a pain reliever and fever reducer. Acetaminophen is used to treat pain.

GeneralMedication

Ibuprofen (generic for Motrin, generic for Advil) is a pain reliever and the most commonly used non-steroidal anti-inflammatory drug (NSAID). Ibuprofen is used to treat pain.

GeneralMedication

Acetaminophen (generic for Tylenol) is a pain reliever and fever reducer. Acetaminophen is used to treat pain.

GeneralMedication

Acetaminophen (generic for Tylenol) is a pain reliever and fever reducer. Acetaminophen is used to treat pain.

GeneralMedication

Ibuprofen (generic for Motrin, generic for Advil) is a pain reliever and the most commonly used non-steroidal anti-inflammatory drug (NSAID). Ibuprofen is used to treat pain.

GeneralMedication

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