Flushed face and headache

Migraine Headaches

Migraines headaches are some of the hardest types of headaches to live with. They usually begin with an intense, throbbing pain on one side of the head, which may spread. They also often cause nausea and vomiting. A migraine can last from a few hours to many days and can make people sensitive to light, smells, and sound. For some people, a warning sign, called an aura, comes just before a migraine attack. It can be a set of visual symptoms, like seeing flickering lights, blind spots, or zigzag lines, or other signs like numbness in a limb or a strange smell.

Doctors aren’t sure what causes migraine headaches. Most researchers believe the headaches begin in the nervous system. Because migraines often run in families, it seems likely that genes play a role, too.

For people who have migraines, many things can bring on an attack. Common triggers include

  • Too much alcohol
  • Caffeine withdrawal
  • Certain foods or smells
  • Naps
  • Dry winds
  • Changes in altitude or seasons
  • Changes in hormones
  • Birth control pills
  • Missing a meal
  • Lack of sleep
  • Neck pain
  • Stuffy rooms

Migraines may also happen after intense emotions such as excitement or anger. Exercise, sex, other types of headaches, or very cold foods can also jump-start a migraine.

When is a Headache a Sign of a Brain Tumor?

A common question about severe or persistent headaches is whether they can be caused by a serious underlying health problem, such as a brain tumor.

The fact of the matter is that headaches are more likely a component of primary headache disorders, such as migraine or tension headaches, rather than due to brain tumors. However, certain factors may indicate that a headache could be symptomatic of a larger issue.

Primary vs. Secondary Headaches

There are two major kinds of headaches: primary headaches, which include migraines, cluster headaches, and tension headaches; and secondary headaches, which are caused by underlying factors such as medical conditions. Both kinds of headaches are common in cancer patients; certain kinds of treatment, such as chemotherapy, radiation therapy, and immunotherapy, can cause headaches.

A red flag that a headache could be indicative of a medical issue is if it is a new or unusual headache — for example, one that causes someone to wake up at night, or one that is associated with changes in position. Another red flag is if the headache is accompanied by other symptoms, such as weight loss. Some headaches can be relieved through over-the-counter pain medication, or by having a cup of coffee, for coffee drinkers – but if the headache is persistent and doesn’t improve like it normally would with typical measures, there could be cause for concern and enough reason to see a primary care physician.

When to See Your Physician

If the headache goes on for a couple of weeks without improvement, or is associated with another neurological symptom, such as weakness on one side of the body, it is recommended to discuss your symptoms with a physician.

Headaches that are new or worsening, especially in a person who doesn’t normally have headaches, may warrant a medical follow-up, as do headaches that are worse in the morning or when the person is laying down. These headaches could also potentially wake someone from their sleep, or be accompanied by nausea or vomiting.

Other red flag symptoms include:

  • Change in quality or severity of headaches, in addition to double or blurred vision or vision loss
  • Headaches that occur in someone who has an active cancer
  • Increasing pressure in the back of the head

The most common brain tumor symptoms are:

  • Persistent room spinning, dizziness, or loss of balance.
  • A seizure or loss of ability to speak
  • Hearing problems
  • Gradually worsening weakness or loss of sensation in an arm or leg
  • Personality changes such as emotional withdrawal or anger, or becoming easily confused

Consult your doctor if you have any overall concerns about your health.

This post originally appeared on Insight, the blog of the Dana-Farber Cancer Institute

Headaches

It’s very rare that headaches are a sign of something serious. But see a doctor if you get headaches a lot or have a headache that:

  • is particularly painful and different from the kinds of headaches you’ve had before
  • doesn’t go away easily
  • follows an injury, such as hitting your head
  • causes you to miss school
  • happens along with any of these symptoms:
    • changes in vision, such as blurriness or seeing spots
    • tingling sensations (such as in the arms or legs)
    • skin rash
    • weakness, dizziness, or trouble walking or standing
    • neck pain or stiffness
    • fever

How Can I Feel Better?

Most headaches will go away if a person rests or sleeps. When you get a headache, lie down in a cool, dark, quiet room and close your eyes. It may help to put a cool, moist cloth across your forehead or eyes. Relax. Breathe easily and deeply.

If a headache doesn’t go away or it’s really bad, you may want to take an over-the-counter pain reliever like acetaminophen or ibuprofen. You can buy these in drugstores under various brand names, and your drugstore may carry its own generic brand. It’s a good idea to avoid taking aspirin for a headache because it may cause a rare but dangerous disease called Reye syndrome.

If you are taking over-the-counter pain medicines more than twice a week for headaches, or if you find these medicines are not working for you, talk to your doctor.

Most headaches are not a sign that something more is wrong. But if your headaches are intense and happen often, there are lots of things a doctor can do, from recommending changes in your diet to prescribing medicine. You don’t have to put up with the pain!

Reviewed by: Elana Pearl Ben-Joseph, MD Date reviewed: September 2018

Why Does My Face Get Hot Before a Migraine?

Q1. I’ve had migraines for about 14 years, but in the last year and a half they have become more frequent. My face will become really hot to the touch and flush. If I can cool my face, I will be fine, but if my face remains hot too long, I will develop a migraine. Is this common? What can be done for this?

It is not common for patients to experience hot, flushed feelings of the face during a migraine. However, I do have patients with similar symptoms. I recall one patient whose nose would become hot and red just prior to the onset of the migraine headache. I presently have a patient whose migraines cause her ears to become warm to the touch and red.

Migraines may cause vasomotor symptoms, such as you described. If these symptoms begin within 60 minutes of the onset of a headache, they are termed “aura” symptoms. Symptoms that begin one to 23 hours prior to a migraine headache are termed premonitory.

Headaches can be caused by several different problems, and there are several types of headaches:

  • Tension headache
  • Tension headache with tender points of the scalp (myofascial)
  • Migraine (common, classical, hemiplegic)
  • “Hormonal” migraine (premenstrual, with “the pill,” in pregnancy, menopausal)
  • Cluster headache
  • Sinus headache
  • Headache from a tooth infection or abscess
  • Headache from jaw joint (temporomandibular joint, TMJ) syndrome
  • Headache from caffeine withdrawal
  • Headache from alcohol use and withdrawal (hangover)
  • Hypertension (high blood pressure) headache
  • Headache from temporal arteritis
  • Lupus headache
  • Headache from rheumatoid arthritis of the cervical spine
  • Headache from cervical spine problems (cervicogenic), including 16 below
  • Headache from entrapment of the occipital nerve(s)
  • Headache before or during a stroke
  • Headache because of a subdural hematoma
  • Headache from a ruptured aneurysm or a vascular malformation in the brain
  • Headache because of brain infection (meningitis, abscess, encephalitis)
  • Headache from increased pressure inside the head (hydrocephalus)
  • Headache from tumors (brain tumor, including acoustic nerve tumor, bone, or bone marrow tumor)

As you can see from this long list, the great variety of headaches and their causes often require thorough investigation by a neurologist specializing in headache diagnosis and care, or by a headache clinic. The International Headache Society has developed a very detailed list of headache types. I will go over a few points about selected types of headache and then address your problem.

The most common of all is the tension headache, seen in 30-78 percent of the population. It is usually localized at the forehead and temples, at times has a vise-like sensation, is felt on both sides, and frequently happens in the afternoon. A variation of tension headache causes sore points on the scalp (the skin covering the skull) that sometimes require injection with local anesthetic medicine.

Migraine headaches are about three times more common in women than in men, and have certain “hormonal connections.” They can occur as part of premenstrual syndrome (PMS), in women taking oral contraceptives, during pregnancy, and during menopause. Migraines usually run in families, start at a relatively young age, and tend to get less frequent with age. There are several types of migraines. The word migraine means that the headache is on one side of the head, although it can affect both right and left sides, or the back of the head (occipital migraine). Bright lights and loud sounds are extremely bothersome to migraine sufferers. There are now specific medicines for migraines that act on the responsible brain receptors.

Cluster headaches affect more men than women, are severe and cause tearing and congestion of the nose. They are triggered by the hypothalamus, a part of the brain, and involve the major nerve of the face, the trigeminal nerve.

Headaches 6 through 10 are self explanatory.

Headaches from temporal arteritis and from lupus are caused by blood vessel inflammation and the treatment is aimed at these systemic diseases. It involves cortisone-like drugs and immunosuppressive drugs.

Rheumatoid arthritis of the upper levels of the cervical spine can cause headaches felt at the neck and back of the head. Sometimes a structural problem — like slippage of vertebrae, called subluxation — presses on the occipital nerves and causes the headache to radiate toward the upper area of the head.

Headaches 17 through 22 are the result of various processes that increase the pressure inside the head. They require immediate medical attention and diagnosis. The treatment varies with the condition.

Your description of your headache, located in the back of the head and the neck, suggests a cervicogenic headache or a compression (entrapment, pinching) of the occipital nerve(s). This type of headache was found in four percent of the Norwegian population and may have a number of causes: flexion-extension (whiplash) injury, herniated cervical disc, arthritis of the facet joints of the cervical spine, poor alignment, prior neck surgery, and narrowing of the spinal canal. Movement of the neck is restricted, especially in the upper part of the neck. The International Headache Society has proposed certain criteria for the diagnosis of cervicogenic headache.

Imaging of the neck should show certain abnormalities. X-rays usually show the most obvious changes, while computed tomography (CAT scan) and magnetic resonance imaging (MRI) show more subtle abnormalities. Sometimes the abnormality may be too subtle to see, even in the MRI. This can be especially true if there is compression of the occipital nerve or nerves (there are three).

The treatment of cervicogenic headache is multifaceted. Physical therapy by an expert spine therapist is extremely important to the overall success of the treatment program. Attention to posture and muscle strengthening are important goals. Pain medications may be helpful, but very often a nerve or nerve root block with a local anesthetic medicine is needed. This is done by a well-trained physician, usually an interventional radiologist, under X-ray or CT guidance. Sometimes injections are given into “trigger” points in the muscle or nearby areas, or even in the epidural space of the spinal canal. A small study reported better nerve block results with botulinum toxin (Botox). At times the nerve or nerve root is cut surgically by a neurological surgeon or an orthopedic spine surgeon.

Acupuncture may be helpful, but the relief is transitory. Osteopathic manipulations or chiropractic adjustments may help too, but I admit that I do not have experience with such treatments. In case of poor alignment (subluxation, malalignment), I would avoid any force on the neck or any manipulations. The reason is that the spinal cord, which lies in the spinal canal, and its blood circulation, may be compromised.

Q2. I have been having bad headaches at the back of my head as well as neck pain for a couple of months. I had an MRI of my head and neck and it came back negative. My doctor thinks I have a pinched nerve in my neck, but wouldn’t that have showed up on an MRI? Could a chiropractor help? Any other suggestions?

Headaches can be caused by several different problems, and there are several types of headaches:

  • Tension headache
  • Tension headache with tender points of the scalp (myofascial)
  • Migraine (common, classical, hemiplegic)
  • “Hormonal” migraine (premenstrual, with “the pill,” in pregnancy, menopausal)
  • Cluster headache
  • Sinus headache
  • Headache from a tooth infection or abscess
  • Headache from jaw joint (temporomandibular joint, TMJ) syndrome
  • Headache from caffeine withdrawal
  • Headache from alcohol use and withdrawal (hangover)
  • Hypertension (high blood pressure) headache
  • Headache from temporal arteritis
  • Lupus headache
  • Headache from rheumatoid arthritis of the cervical spine
  • Headache from cervical spine problems (cervicogenic), including 16 below
  • Headache from entrapment of the occipital nerve(s)
  • Headache before or during a stroke
  • Headache because of a subdural hematoma
  • Headache from a ruptured aneurysm or a vascular malformation in the brain
  • Headache because of brain infection (meningitis, abscess, encephalitis)
  • Headache from increased pressure inside the head (hydrocephalus)
  • Headache from tumors (brain tumor, including acoustic nerve tumor, bone, or bone marrow tumor)

As you can see from this long list, the great variety of headaches and their causes often require thorough investigation by a neurologist specializing in headache diagnosis and care, or by a headache clinic. The International Headache Society has developed a very detailed list of headache types. I will go over a few points about selected types of headache and then address your problem.

The most common of all is the tension headache, seen in 30-78 percent of the population. It is usually localized at the forehead and temples, at times has a vise-like sensation, is felt on both sides, and frequently happens in the afternoon. A variation of tension headache causes sore points on the scalp (the skin covering the skull) that sometimes require injection with local anesthetic medicine.

Migraine headaches are about three times more common in women than in men, and have certain “hormonal connections.” They can occur as part of premenstrual syndrome (PMS), in women taking oral contraceptives, during pregnancy, and during menopause. Migraines usually run in families, start at a relatively young age, and tend to get less frequent with age. There are several types of migraines. The word migraine means that the headache is on one side of the head, although it can affect both right and left sides, or the back of the head (occipital migraine). Bright lights and loud sounds are extremely bothersome to migraine sufferers. There are now specific medicines for migraines that act on the responsible brain receptors.

Cluster headaches affect more men than women, are severe and cause tearing and congestion of the nose. They are triggered by the hypothalamus, a part of the brain, and involve the major nerve of the face, the trigeminal nerve.

Headaches 6 through 10 are self explanatory.

Headaches from temporal arteritis and from lupus are caused by blood vessel inflammation and the treatment is aimed at these systemic diseases. It involves cortisone-like drugs and immunosuppressive drugs.

Rheumatoid arthritis of the upper levels of the cervical spine can cause headaches felt at the neck and back of the head. Sometimes a structural problem — like slippage of vertebrae, called subluxation — presses on the occipital nerves and causes the headache to radiate toward the upper area of the head.

Headaches 17 through 22 are the result of various processes that increase the pressure inside the head. They require immediate medical attention and diagnosis. The treatment varies with the condition.

Your description of your headache, located in the back of the head and the neck, suggests a cervicogenic headache or a compression (entrapment, pinching) of the occipital nerve(s). This type of headache was found in four percent of the Norwegian population and may have a number of causes: flexion-extension (whiplash) injury, herniated cervical disc, arthritis of the facet joints of the cervical spine, poor alignment, prior neck surgery, and narrowing of the spinal canal. Movement of the neck is restricted, especially in the upper part of the neck. The International Headache Society has proposed certain criteria for the diagnosis of cervicogenic headache.

Imaging of the neck should show certain abnormalities. X-rays usually show the most obvious changes, while computed tomography (CAT scan) and magnetic resonance imaging (MRI) show more subtle abnormalities. Sometimes the abnormality may be too subtle to see, even in the MRI. This can be especially true if there is compression of the occipital nerve or nerves (there are three).

The treatment of cervicogenic headache is multifaceted. Physical therapy by an expert spine therapist is extremely important to the overall success of the treatment program. Attention to posture and muscle strengthening are important goals. Pain medications may be helpful, but very often a nerve or nerve root block with a local anesthetic medicine is needed. This is done by a well-trained physician, usually an interventional radiologist, under X-ray or CT guidance. Sometimes injections are given into “trigger” points in the muscle or nearby areas, or even in the epidural space of the spinal canal. A small study reported better nerve block results with botulinum toxin (Botox). At times the nerve or nerve root is cut surgically by a neurological surgeon or an orthopedic spine surgeon.

Acupuncture may be helpful, but the relief is transitory. Osteopathic manipulations or chiropractic adjustments may help too, but I admit that I do not have experience with such treatments. In case of poor alignment (subluxation, malalignment), I would avoid any force on the neck or any manipulations. The reason is that the spinal cord, which lies in the spinal canal, and its blood circulation, may be compromised.

Q3. I get migraines directly on my left eyebrow. Can you tell me if this is where the trigeminal nerve lies and what its role is in migraines? Also, I have had some migraines with strange symptoms. I will get a crackling noise in my head with a lightning bolt jolt, and for a split second it affects my vision. My speech becomes slurred; it’s hard to form the words I want to say and very difficult to concentrate. This is extremely embarrassing, especially when I am at work dealing with customers, and my boss asks me if I am on drugs!

There are 12 cranial nerves on each side of the head. The cranial nerves originate in the brainstem. The trigeminal nerve, also known as the fifth cranial nerve, is responsible for the production of nearly all external and internal sensations of pain, temperature and touch to the head and face, including head pain (headache). The trigeminal nerve has three major branches – the ophthalmic nerve, which carries sensation from the eye area and forehead; the maxillary nerve, which carries sensation from the middle part of the face; and the mandibular nerve, which carries sensation from the lower part of the mouth and the jaw.

The trigeminal nerve has endings on blood vessels located on the brain’s outer surface. Certain trigger factors may stimulate these nerve endings in such a way that a series of chemical events occur, leading to the blood vessels dilating and leaking. Migraine symptoms result. Migraine headaches can include all of the symptoms you listed.

If you are concerned about how your symptoms affect your performance at work or your relationship with your boss, perhaps you should ask your physician to document your migraine symptoms in a letter that you can present to your employer.

Your migraines may be frequent enough to warrant preventive medication. Ask your doctor for more information.

Learn more in the Everyday Health Headache and Migraine Center.

Flushing, Drooping, Tearing, and Stuffiness… Autonomic Symptoms in Headache

Key Points:

  1. Autonomic symptoms are common with different types of headaches including migraine and trigeminal autonomic cephalalgias.
  2. Look at yourself in the mirror when you have a headache and observe changes such as facial flushing, eyelid drooping, or tearing. Pay attention to sensations of ear fullness or nasal congestion. Notice if these are happening on one or both sides of your head. This information will be very useful in making the correct headache diagnosis.
  3. You may have a headache that is different from a migraine or sinus pain and that can be treated differently and completely as in the case of indomethacin-responsive headaches.

Facial flushing, eyelid drooping or swelling, eye redness, tearing, nasal stuffiness, sweating, and ear fullness are referred to as “autonomic symptoms.” These are transmitted by the autonomic nervous system which controls functions of glands (sweating, tearing), adrenaline release, and level of alertness, and many other involuntary functions. Autonomic symptoms are commonly associated with different types of headaches and can help make the correct diagnosis.

As many as 70% of adult migraineurs experience some autonomic symptoms. Pain sensing nerves of the brain covering, or the dura, are irritated in migraine. These nerves can activate the autonomic system, which produces autonomic symptoms. With migraine, in addition to throbbing head pain, light and noise sensitivity and nausea, autonomic symptoms typically occur on both sides of the head.

Nasal stuffiness, eyelid swelling, and tearing with headache are frequently misdiagnosed as “sinus headache.” Similar symptoms can occur in migraine and in sinus related pain because the same nerves that carry sensation from the brain covering also carry sensation from the face and sinuses, which can initiate autonomic symptoms. Nasal congestion does not necessarily mean that your headache is sinus related. Review “Sinus Headaches” for more information.

It is important to be aware of autonomic symptoms and to note when and where they are happening. Symptoms affecting only one side of the face, particularly the side where the head pain is most severe, suggest a different class of headache disorders. Hemicrania continua, paroxysmal hemicrania, cluster headache, and several other rare disorders are all associated with one-sided head pain, and autonomic symptoms and are categorized as “trigeminal autonomic cephalalgias.”

Hemicrania continua can be easily misdiagnosed as migraine. This is because the pain exacerbations of hemicrania continua can last many hours just as migraine, and can be associated with light and noise sensitivity. In both disorders, patients frequently experience autonomic symptoms. In hemicrania continua, it is part of the definition of the headache diagnosis and is present in up to 95% of patients. One of the differences between migraine and hemicrania continua is presence of autonomic signs just on one side of the head during pain exacerbations in hemicrania continua. Additionally, patients may notice that the photophobia and phonophobia are also more predominant on one side.

Next time you have a headache, look at yourself in the mirror and carefully observe your symptoms. Take notice of one-sided flushing or redness of the face, increased sweating, tearing or redness of one eye, drooping or swelling of one eyelid, small pupil on one side, nasal or ear fullness. If you are diagnosed with Migraine, but are not getting sufficient relief with prescribed migraine medications, make sure to mention to the doctor treating you for migraines that the symptoms you experience are on one side. You may need to be evaluated for trigeminal autonomic cephalalgias.

The correct diagnosis may make a huge difference for you because several of the trigeminal autonomic headaches are completely treatable. Hemicrania continua and paroxysmal hemicrania are most remarkable in that they both can resolve on daily indomethacin treatment. In fact, response to indomethacin is a part of the diagnosis. Indomethacin is a non-steroidal anti-inflammatory drug with a structure similar to melatonin. Melatonin has also been used to treat these disorders. Different treatments are also available for cluster headaches and other trigeminal autonomic cephalalgias.

Pay attention to your symptoms: you may have the key to the correct diagnosis and better treatment for your headache.

Looking for a list of symptoms?

If you are looking for a list of symptoms and signs of high blood pressure (HBP or hypertension), you won’t find them here. This is because most of the time, there are none.

Myth: People with high blood pressure will experience symptoms, like nervousness, sweating, difficulty sleeping or facial flushing.

Truth: High blood pressure is a largely symptomless “silent killer.” If you ignore your blood pressure because you think a certain symptom or sign will alert you to the problem, you are taking a dangerous chance with your life.

AHA recommendation

  • DO NOT attempt to diagnose yourself. Clinical diagnosis should only be made by a healthcare professional.
  • Know your blood pressure numbers and make changes that matter to protect your health.

In most cases, high blood pressure does not cause headaches or nosebleeds

  • The best evidence indicates that high blood pressure does not cause headaches or nosebleeds, except in the case of hypertensive crisis, a medical emergency when blood pressure is 180/120 mm Hg or higher. If your blood pressure is unusually high AND you have headache or nosebleed and are feeling unwell, wait five minutes and retest. If your reading remains at 180/120 mm Hg or higher, call 911.
  • If you are experiencing severe headaches or nosebleeds and are otherwise unwell, contact your doctor as they could be symptoms of other health conditions.

Other inconclusively related symptoms

A variety of symptoms may be indirectly related to, but are not always caused by, high blood pressure, such as:

  • Blood spots in the eyes : Blood spots in the eyes (subconjunctival hemorrhage) are more common in people with diabetes or high blood pressure, but neither condition causes the blood spots. Floaters in the eyes are also not related to high blood pressure. However, an eye doctor (ophthalmologist) may be able to detect damage to the optic nerve caused by untreated high blood pressure.
  • Facial flushing: Facial flushing occurs when blood vessels in the face dilate. It can occur unpredictably or in response to certain triggers such as sun exposure, cold weather, spicy foods, wind, hot drinks and skin-care products. Facial flushing can also occur with emotional stress, exposure to heat or hot water, alcohol consumption and exercise — all of which can raise blood pressure temporarily. While facial flushing may occur while your blood pressure is higher than usual, high blood pressure is not the cause of facial flushing.
  • Dizziness : While dizziness can be a side effect of some blood pressure medications, it is not caused by high blood pressure. However, dizziness should not be ignored, especially if the onset is sudden. Sudden dizziness, loss of balance or coordination and trouble walking are all warning signs of a stroke. High blood pressure is a leading risk factor for stroke.

ON THIS PAGE: You will find out more about body changes and other things that can signal a problem that may need medical care. Use the menu to see other pages.

People with mastocytosis may experience the following symptoms or signs. Sometimes, people with mastocytosis do not have any of these changes. Or, the cause of a symptom may be a different medical condition that is not mastocytosis.

General symptoms of mastocytosis

  • Hives

  • Red, itchy rash

  • Diarrhea

  • Abdominal pain

  • Fainting

  • Facial flushing or reddening of the face

  • Shortness of breath

  • Wheezing or trouble breathing

  • Psychological changes, such as irritability or difficulty concentrating

Symptoms of urticaria pigmentosa

  • Tan or red-brown spots on the skin

  • Abdominal pain

  • Nausea

  • Vomiting

  • Diarrhea

  • Headache

  • Increased heart rate

  • Flushed face

  • Psychological changes

Symptoms of solitary mastocytoma

  • Raised or flat reddish-brown spot on the skin

  • Hives

  • Itching

Symptoms of diffuse erythrodermic mastocytosis

  • Thickening of the skin

  • Blisters

Symptom of telangiectasia macularis eruptiva perstans

  • Small lesions that do not itch

Symptoms of systemic mastocytosis

  • Skin lesions

  • Urticaria pigmentosa

  • Flushed face

  • Itching

  • Nausea

  • Vomiting

  • Diarrhea

  • Abdominal pain

  • Ulcers in the stomach and duodenum (small intestine)

  • Headache

  • Lightheadedness

  • Heart palpitations, an irregular or unusually rapid beating of the heart

  • Bone pain

  • Anemia, a low red blood cell count, which can cause fatigue

  • Psychological changes

The symptoms of systemic mastocytosis can sometimes occur as “attacks,” where more than 1 symptom appears at the same time. Following an attack, the person may feel tired and lethargic.

If you are concerned about any changes you experience, please talk with your doctor or a dermatologist, a doctor who specializes in skin conditions. Your doctor will ask how long and how often you’ve been experiencing the symptom(s), in addition to other questions. This is to help figure out the cause of the problem, called a diagnosis.

If mastocytosis is diagnosed, relieving symptoms is an important part of your care and treatment. This may also be called symptom management, palliative care, or supportive care. Be sure to talk with your health care team about the symptoms you experience, including any new symptoms or a change in symptoms.

The next section in this guide is Diagnosis. It explains what tests may be needed to learn more about the cause of the symptoms. You may use the menu to choose a different section to read in this guide.

When should you worry about a headache?

Headaches are really common. In fact, Headache Australia says they’re one of the most common symptoms experienced by humans, with more than 5 million Australians affected by headaches and migraines.

Even though it’s so common, if you’ve got a headache that’s sudden, severe or lasting, you might be worried that there’s a serious problem. So how do you know when a headache is something you can treat at home, or when you should see your doctor?

Let’s explore what a headache is, how you might treat it at home and when you should get medical advice.

What is a headache?

Technically, a headache can be any pain in the head, face or neck area. Headaches might be caused by muscle tension, nerve pain and dehydration, be a symptom of another illness, or be bought on by certain foods and drinks or medications.

There are two overarching types of headache: primary and secondary. Primary headaches are the most common, describing headaches that ‘just happen’ without an underlying illness or injury causing them. These include tension headaches, migraines and cluster headaches. Secondary headaches have a separate cause, like an existing illness, hormonal changes, sinus or tooth inflammation or a side effect of medication or drugs.

Beyond these two broad classifications, Headache Australia lists 36 different types of headache. You can read more about different types of headaches, from hot-dog headaches to hangovers, on the Headache Australia website.

How to treat a headache

Because there are so many different types of headache, there are lots of different ways they can be treated.

If your headaches are frequent, keeping a diary that lists when you get headaches might help you figure out what triggers them. If there’s an obvious cause, like a tight neck, dehydration, or having too much caffeine, you might be able to avoid headaches by changing your behaviour or lifestyle.

When you have a headache, the below steps can help relieve the pain.

  • rest and relax in a quiet space with good ventilation
  • drink plenty of water
  • put a cool cloth or ice pack on your head
  • splash your face with cold water
  • if you have a tension headache, massage your neck, jaw, shoulders and head
  • talk to your pharmacist about what pain medication you can take – this might change depending your health, if you are taking any other medications and the type of headache you have.

Try these tips for preventing headaches:

  • eat regularly, fuelling your body with nutritious foods, as dropping blood glucose levels can trigger headaches
  • drink plenty of water, more if you’ve been exercising or it’s a hot day to avoid dehydration
  • make sure you aren’t in a room that is too hot or too cold, and has plenty of fresh air
  • exercise regularly
  • try not to sit or stand in the same position for too long, as this can cause muscle tension
  • avoid chocolate, caffeine, alcohol and tobacco, all of which can cause headaches
  • see your optometrist for an eye test
  • and avoid overusing headache medicines – too frequent use can cause ‘rebound’ headaches.

When should you see a doctor about a headache?

Headaches not only cause you pain, but can result in loss of productivity and income. If you have ongoing headaches, it’s important to see your doctor to try and figure out the cause, rather than just put up with the pain. Keep in mind that most headaches do not point to a serious illness, extra worry about your headache might make it worse!

See your doctor if your headaches are frequent, you’ve had a headache for more than a few days, or your headaches are causing you stress or worry.

Rarely, a headache might be a sign of a serious medical condition. You should seek immediate medical attention if you:

  • have a sudden, very severe headache, and it’s the first time it’s happened
  • are experiencing any of the signs of stroke including a dropped face on one side; droopy mouth or eye; cannot lift one or both arms; or have slurred or garbled speech
  • have a headache accompanied by a stiff neck and fever
  • have signs of severe dehydration or heat stroke
  • may have been poisoned by ingesting, inhaling or touching a substance, or being bitten or stung by a poisonous animal or plant (call the Queensland Poisons Information Centre helpline on 13 11 26 for advice 24 hours, 7 days a week)
  • or have injured your head from a fall, blow or bump.

ON THIS PAGE: You will find out more about body changes and other things that can signal a problem that may need medical care. Use the menu to see other pages.

A GI tract NET often causes no symptoms in its early stages. This type of tumor is usually found by a surgeon during an unrelated surgery or on x-rays for another condition. People with a GI tract NET may experience the following symptoms or signs. The signs and symptoms of carcinoid syndrome and carcinoid crisis, conditions that a GI tract NET can cause, are also described. However, the cause of a symptom may be a different medical condition that is not a GI tract NET.

If you are concerned about any changes you experience, please talk with your doctor. Your doctor will ask how long and how often you’ve been experiencing the symptom(s), in addition to other questions. This is to help figure out the cause of the problem, called a diagnosis.

Symptoms of a GI tract NET

GI tract NETs may cause tumor-related symptoms. GI tract NETs are also the type of NET most likely to cause carcinoid syndrome (see below), which has its own set of symptoms.

People with a GI tract NET may experience the following tumor-related symptoms or signs:

  • Abdominal pain caused by blockage of the intestines

  • Diarrhea, especially in people who have carcinoid syndrome, had part of their intestines removed, or had their gallbladder removed.

  • Rash

  • Bright, red blood in the stool or dark, tarry stool. This is a sign of intestinal bleeding.

  • Scale-like skin sores, which can be a sign of pellagra, a severe deficiency of vitamin B3

  • Mental disturbances, another sign of pellagra

  • Constipation

  • Nausea and vomiting

  • Weight loss that cannot be explained

  • Jaundice, which is when the skin and whites of the eyes turn yellow

  • Fatigue

Carcinoid syndrome

Carcinoid syndrome is the classic example of a functional NET and occurs most commonly in patients with small intestine and lung NETs that have spread to another part of the body, called metastatic. In carcinoid syndrome, serotonin is produced by the tumor and can cause 1 or more of the following symptoms or signs. Serotonin is most easily and reliably measured in the urine, when it gets converted into 5-hydroxyindoleacetic acid (5-HIAA), and it is measured with a 24-hour collection. Not all people with a GI tract NET develop carcinoid syndrome.

People with carcinoid syndrome may experience 1 or more of the following symptoms or signs. It is important to note that these symptoms alone are not enough to diagnose carcinoid syndrome. Blood or urine tests to measure for suspected hormones are also needed to make a diagnosis.

  • Facial flushing, which is redness and a warm feeling over the face

  • Sweating

  • Diarrhea

  • Shortness of breath

  • Wheezing or asthma-like symptoms

  • Unexplained weight gain

  • Weakness

  • Fast heartbeat

  • Heart murmur

  • High blood pressure and significant fluctuations in blood pressure

  • Carcinoid heart disease, which is a scarring of the heart valves

Carcinoid syndrome may damage the heart, so reducing its symptoms is important. Stress, strenuous exercise, and drinking alcohol may make these symptoms worse. Some foods may also trigger the symptoms of carcinoid syndrome, including foods high in:

  • Amines, such as aged cheeses, yeast extracts, tofu, sauerkraut, and smoked fish and meats

  • Serotonin, such as walnuts, pecans, plantains, bananas, and tomatoes

Carcinoid crisis

Carcinoid crisis is a term used when patients experience severe, sudden symptoms of carcinoid syndrome, usually in times of extreme stress, such as surgery. Carcinoid crisis primarily includes serious fluctuations in blood pressure and heart rate. Carcinoid crisis is the most serious and life-threatening complication of carcinoid syndrome. A carcinoid crisis may be prevented and successfully treated with octreotide (Sandostatin), a medication that helps control the production of hormones, or lanreotide (Somatuline Depot).

Managing symptoms

If a GI tract NET is diagnosed, relieving symptoms remains an important part of cancer care and treatment. This may be called palliative care or supportive care. Below is information on how some of the symptoms of a GI tract NET can be managed. Be sure to talk with your health care team about the symptoms you experience, including any new symptoms or a change in symptoms.

  • Facial flushing. Avoid stress. Ask your doctor about specific substances and foods, including alcohol, that can cause facial flushing, so you can avoid them.

  • Wheezing. Ask your doctor about the use of a bronchodilator, a medication that relaxes the muscles in the lungs to make breathing easier.

  • Diarrhea. There can be many causes of diarrhea in people with NETs. If your diarrhea is caused by carcinoid syndrome, somatostatin analogs and telotristat ethyl (Xermelo) can help. If the diarrhea is caused by bile acid malabsorption, which occurs after removal of the gallbladder, ursodiol (Actigall, URSO 250, URSO Forte) can help. If a lack of pancreatic digestive enzymes has caused the diarrhea, replacement enzymes can help. Ask your doctor for specific recommendations.

  • Heart problems. Tell your doctor immediately if you think you may have a problem with your heart and ask about the use of diuretics. Diuretics are drugs that lower blood pressure by helping the body get rid of water and sodium.

Learn more about managing common cancer symptoms and treatment side effects.

The next section in this guide is Diagnosis. It explains what tests may be needed to learn more about the cause of the symptoms. Use the menu to choose a different section to read in this guide.

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