LYCOS RETRIEVER 
Headache: Headaches
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Because the onset of cluster headache attacks is rapid and may occur several times a day, the best approach to treatment is with daily preventive drugs. Effective prophylactic medications include verapamil HCl, prednisone, lithium carbonate, methysergide (not available in the US), and the antiepileptic drugs divalproex and topiramate. High doses of verapamil (480 mg to 720 mg/day) may be necessary. Prednisone and methysergide work quickly and often will be used with verapamil or lithium at onset for a quick response and then tapered while the verapamil or lithium is continued. Prednisone is usually prescribed at 60 mg/day initially and then tapered over 2 to 3 weeks. There are reports that topiramate is helpful is controlling cluster but no controlled studies have been published.
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Researchers randomized 81 tension headache sufferers to six weeks of physiotherapy including massage and other techniques (the control group), or to the same physiotherapy program plus CTP (the experimental group). People in the craniocervical training group underwent 15 minutes of instruction on the technique, which involves flexing the head and neck with light resistance supplied by a latex band. They were then told to perform the exercises at home for 10 minutes twice daily. During the six-week program, headache frequency, intensity and duration fell in both groups, with no significant between-group differences. However, headaches had worsened among people in the control group by six months after the end of the exercise program. At the end of the exercise program, 52 percent of people in the control group experienced a 50 percent or more reduction in headache frequency, but just 35 percent had this amount of reduction in headache frequency six months later.
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The most important step in diagnosing a headache is for the physician to take a careful history and to examine the patient. In the majority of cases the diagnosis will be a "primary headache" which means that the headache, whilst unpleasant is not an occurring as a manifestation of a more serious condition. The main types of primary headache are tension headache, migraine and the trigeminal autonomic cephalalgias of which cluster headache is an example. As it is often difficult for patients to recall the precise details regarding each headache, it is often useful for the sufferer to fill-out a "headache diary" detailing the characteristics of the headache. When the headache does not clearly fit into one of the recognized primary headache syndromes or when atypical symptoms or signs are present then further investigations are justified.[1] Computed tomography (CT/CAT) scans of the brain or sinuses are commonly performed, or magnetic resonance imaging (MRI) in specific settings. Blood tests may help narrow down the differential diagnosis, but are rarely confirmatory of specific headache forms.
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The usual tension headache is described as a tightening around the head and neck, accompanied by a steady ache that forms a tight band around the forehead. Tension headaches usually affect both sides of the head and usually appear at the front of the head, although they can appear at the top or back of the skull. Tension headaches often begin in the afternoon and can last for several hours. They can occur every day. When this happens it is called a chronic tension headache.
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Constriction of the blood vessels may ... occur in any part of the cerebral vascu-lature and cause the neurologic symptoms associated with some forms of vascular headache. Migraine affects one side of the head but may be bilateral. Nerologic symptoms, especially visual disturbances, are common. Cluster headache is the occurrence of migraines in groups or series. The cluster headache is characterized by its one-sided, excruciating attack that is usually localized around one eye. Other forms ofvascular headache may be caused by systemic infection or fever, which causes dilation of the blood vessels.
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Some of the things that you eat and drink may affect the vascular type of headache. For example, some people who drink red wine will get an instant headache. There is an amino acid in red wine that can trigger a headache. In general, it's a good idea to avoid drinking alcohol following a head injury (a hangover is the brain's way of reminding you that you are hurting it). The same amino acid in red wine is ... found in some foods (such as hard cheeses). An allergic reaction may also cause a headache.
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