Side Effect: Headache

What is a headache?

Headaches are characterized by pain originating in the head, or radiating from the neck into the head.

Three types of primary headache exist:

1) Migraine
2) Tension
3) Cluster

Primary headaches can be recurrent, and are usually benign, meaning they do not have a damaging effect on the body once they go away.

Secondary headaches are from known causes including, but not limited to, the following:

1) Bleeding
2) Clotting
3) Infection

What does Headache look like?

Most headaches do not show any visible signs and are not tied to other symptoms and it may be hard to describe the headache beyond where it hurts and how much it hurts. However, certain causes of headache may be accompanied by various signs or symptoms, therefore it is important to know what these are:

Headache from meningitis may also present with:

• Fever
• Rigid neck
• Confusion or altered mental status

Headache from medication may also present with:

• Nausea or vomiting shortly after taking the medication

Headache from bleeding or clotting may also present with:

• Confusion or altered mental status
• Loss of function on one side of the body
• Slurred speeach
• Inability to formulate words
• Change in ability to walk

Who gets headaches?

In order to determine what the headache is from, the clinician will take a thourough history and conduct a focused examination.

The vast majority of headaches experienced by people are primary headaches, such as cluster or migraines. These can be brought on by many different things such as stress, dehydration, and certain medications.

Patients with cancer, or those receiving treatment for cancer, may be at higher risk of other cause of headache. Although these are much more rare, these causes of headache require immediate medical treatment:

• Brain mass (tumor) or lesion
• Infection causing meningitis
• Blood clot in the brain (thrombotic stroke)
• Bleeding in the brain (hemorrhagic stroke)

How do you prevent headaches?

Lifeastyle modifications:

• The best way to prevent certain types of headache are to stay hydrated by drinking enough water, and to avoid triggers such as certain foods or drink.

Life stressors:

• Stress can precipitate headaches. Visit our emotional wellness page to learn more about ways to cope with life stressors.

Medication-induced headache:

• Common medications taken by patients undergoing cancer treatment, such as ondansetron (Zofran®), may increase the risk of a headache
• Ask your doctor or pharmacist to look over your medication list to see if any of the medications you are taking might be contributing to the development of headaches

Patients taking an anticoagulant with headache:

• If you are taking a blood thinner, be sure to have a pharmacist double check the rest of your medications to ensure that there are no drug interactions that could lead to higher levels of blood thinner in your body as this may increase the risk of a stroke due to bleeding in the brain. Likewise, be sure to follow your doctor's instructions to reduce your risk of the blood thinner not working, which may increase your risk of a stroke due to a blot clot that travels to the brain

Medications to prevent headaches:

Botox injections:

• Frequent headaches due to medication that must be taken daily to treat a disease can be difficult to deal with. Botox injections have been shown to be helpful to some patients in situations such as these

Beta-Blockers

• These are medications that are used to lower blood pressure, which may help to prevent certain types of headaches.
• Propranolol is one example of a beta-blocker commonly used to prevent headaches
  • Note: These medications may contribute to exercise intolerance and fatigue

How do you treat headaches?

Before you treat a headache with any over-the-counter medications such as acetaminophen (Tylenol®), or ibuprofen (Advil®, Motrin®), or naproxen (Aleve®), ask your doctor or pharmacist if they are safe to take. with your other medications.

• Certain cancer treatments can suppress the immune system making it more likely that an infection could occur. Medications such as acetaminophen or ibuprofen may mask a fever, thereby delaying when it is that you seek medical attention. This could be dangerous if you are neutropenic, where part of the immune system is suppressed.

Prescription medications use to treat headache:

Triptans:

• Sumatriptan

Barbiturate-containing medications:

• Fioricet
• Fiorinal