Organic Headaches - Types, Causes, Symptoms, Diagnosis, and Treatment

Introduction

Every single individual has complained of headaches sometime during their life. So yes, headaches are one of the most common medical conditions, with a lifetime prevalence of 96 percent. Unfortunately, it is also why some people miss their work, school, or duties. The cause behind headaches can be as simple as tension or as serious as a significant medical condition. Although most headaches are not serious, an underlying pathology should be suspected. According to the international classification of headache disorders, headaches are broadly classified into primary and secondary. The primary headache disorders include migraine, tension-type headaches, or cluster headaches. A secondary headache is merely a symptom of an underlying medical condition.

What Are Organic Headaches?

Organic headaches are also known as secondary headaches. They are not a disease condition but rather a reflection of an underlying medical condition. Less than 10 percent of all headache cases are diagnosed as organic or secondary headaches. Therefore, while diagnosing the type of headache, the physician must evaluate the history to rule out other underlying causes.

What Are the Symptoms of Organic or Secondary Headaches?

Certain red flags delineate primary headaches from organic headaches. These include:

• Sudden and abrupt onset of a headache without previous history of the same.

• Change in the pattern of usually experienced headaches.

• Headaches occur at unusual ages (above 50 years or below five years).

• History of systemic conditions like cancer, pregnancy, or HIV (human immunodeficiency virus).

• The onset of headache with seizures or loss of consciousness.

• Exertion of headache after activities like sex or sneezing.

• Neurological symptoms like trouble concentrating, irritability, etc.

What Causes Organic Headaches?

A diverse group of systemic conditions can cause organic headaches. The categories are as follows:

A. Organic Headaches Due to Head Injury: Some people experience a headache after an injury or trauma because of the muscle tension during the trauma. The blood vessels also narrow down, and as a result, people experience pulsating headaches, nausea, and vomiting.

B. Headache Due to Vascular Disorders: Abnormalities in the blood vessels or disorders are often associated with headaches. The symptoms can indicate a serious underlying condition. Examples of these conditions include:

1. Subarachnoid Hemorrhage: Bleeding occurring in the space present between the brain and its surrounding membranes.
2. Acute Ischemic Cerebrovascular Disorder: This is a condition characterized by a sudden or acute stoppage in the blood circulation in a particular brain region. It is a serious condition that leads to neurological dysfunction.
3. Unerupted Vascular Malformation: Denotes malformation of the arteries and veins in the brain. These conditions are congenital (present at birth) and are characterized by an abnormal connection between the arteries and veins.
4. Venous Thrombosis: Characterized by the presence of a blood clot in any vein of the brain caused due to severe dehydration, obesity, brain tumor, etc. It is a life-threatening condition if not treated early.
5. Arterial Hypertension: Hypertension or high blood pressure in the cranial arteries causes poor blood flow and low oxygen supply, followed by irreversible damage to the brain.
6. Arteritis: Inflammation of the arteries in the cranial blood vessels leading to damage and associated complications.

C. Organic Headache Due to Non-Vascular Intracranial Disorder: Headaches can also occur due to disorders unrelated to the cranial blood vessels. In addition, other conditions that cause some imbalance inside the skull can cause headaches. These disorders are often diverse and complex.

1. Low Cerebrospinal Fluid Pressure: The cerebrospinal fluid (CSF) is a colorless body fluid that occupies and flows in the hollow spaces of the brain and spinal cord (central nervous system). A low CSF pressure leads to neurological symptoms like headaches.
2. Intracranial Neoplasm: Intracranial tumors are abnormal masses that grow inside the brain. These tumors can be cancerous or non-cancerous and cause severe headaches.
3. Neurosarcoidosis: This is a rare yet severe manifestation of sarcoidosis, a disease characterized by the growth and accumulation of inflammatory cells in various body parts.
4. Intracranial Infections: Brain infections are caused by viruses, bacteria, fungi, and protozoa. It is a life-threatening condition that affects the brain, surrounding membranes, and spinal cord.

D. Organic Headache Due to Substance Use or Withdrawal: Substance abuse is associated with chronic or acute headaches due to dependency and withdrawal. Patients often complain of a mixed-type and migraine-like headache. Substances most commonly associated with substance abuse are NSAIDs (non-steroidal anti-inflammatory drugs), Barbiturates, Opioids, narcotics, Ergot alkaloids, etc. The patients can get migraine prescription online at telemedicine portals or at in-office doctor's visit.

E. Headaches Due to Metabolic Disorders: Headaches are a prevalent symptom of several metabolic disorders. Conditions like hypoxia and hypercapnia cause headaches due to low oxygen saturation and excess carbon dioxide in the body, especially at high altitudes where the atmospheric oxygen concentration is low. Headaches due to metabolic conditions often mimic primary headaches.

1. Hypoxia: Low oxygen saturation in the blood is known as hypoxia. It can be caused due to underlying diseases of the heart, lungs, or at high altitudes.
2. Hypercapnia: Having a higher concentration of carbon dioxide in the blood is known as hypercapnia due to chronic lung disease.
3. Dialysis: Due to the imbalance in large amounts of water and electrolytes during dialysis (an artificial procedure to remove waste products from the body), patients complain of severe headaches.
4. Hypoglycemia: Low blood sugar levels in the body can cause symptoms such as throbbing headache, fatigue, shakiness, etc.

F. Organic Headache : Due to Infections Outside the Brain: Headache is a common symptom of many systemic bacterial and viral infections. They directly or indirectly cause headaches and are usually related to the body’s immune response. Infections involving the upper respiratory tract cause headaches due to nasal passage and sinus congestion. Infections like Influenza, common flu, HIV, and bacterial sepsis are attributed to organic headaches.

How Are Organic Headaches Diagnosed?

Diagnosing organic headaches is tricky as multiple underlying causes are involved. Therefore, clinicians must carefully evaluate the symptoms and prescribe the necessary tests accordingly. For example, an additional blood test, CT (computed tomography) scan, MRI (magnetic resonance imaging), and X-rays might be required to visualize the underlying pathology.

What Are the Treatment Options Available for Organic Headaches?

It is important to identify the underlying condition before treating a secondary headache. Eliminating the cause will help in relieving the symptoms. Most physicians prescribe over-the-counter (OTC) painkillers like Ibuprofen, Aspirin, and Acetaminophen. Physical therapy like massages and stress management are advised if these medications fail.

Conclusion:

Organic headaches are also known as secondary headaches. They are not a disease condition but rather a symptom of an underlying medical condition. Ten percent of all diagnosed headaches constitute organic headaches. Conditions like brain tumors, blood vessel malformations, hypoxia, and infections can cause secondary headaches. Therefore, it is crucial to identify these conditions before carrying out the treatment protocol.