Traction and Inflammatory Headaches
Headaches may accompany several conditions that can lead to strokes, including hypertension or high blood pressure, arteriosclerosis, and heart disease. Headaches can also occur after a stroke, when the brain cells die from a lack of sufficient oxygen.
Careful management of the patient's condition through diet, exercise, and medication can prevent many stroke-related headaches.
Mild-to-moderate headaches can be related to transient ischemic attacks (TIAs), sometimes called "mini-strokes," which result from a temporary lack of blood supply to the brain. The head pain occurs near the clot or lesion that blocks the flow of blood. The similarities between migraines and symptoms of a TIA can cause problems in diagnosis. The rare person under the age of 40 who suffers a TIA may be misdiagnosed as having a migraine. Similarly, TIA-prone older patients who suffer from migraines may be misdiagnosed as having stroke-related headaches.
About one-fourth of the people who undergo a lumbar puncture or spinal tap develop a headache. Many scientists believe that these headaches result from a leakage of the cerebrospinal fluid (the fluid that flows through pain-sensitive membranes around the brain and down to the spinal cord). The fluid, they suggest, drains through the tiny hole created by the spinal tap needle, causing the membranes to rub painfully against the bony skull.
Since headache pain occurs only when the patient stands up, the "cure" is to remain lying down until the headache runs its course -- anywhere from a few hours to several days.
Headaches can also develop after a blow to the head, either immediately or months later. There is little relationship between the severity of the trauma and the intensity of the headache pain.
In most cases, the cause of the headache is unknown. Occasionally, the cause is ruptured blood vessels, which result in an accumulation of blood called a hematoma. This mass of blood can displace brain tissue and cause headaches, as well as weakness, confusion, memory loss, and seizures.
Hematomas can be drained to produce rapid relief of symptoms.