Whether it is piercing or pounding, throbbing or split­ting, dull pain encircling the whole head, or the mig­rainous on one side only, recent researches have' shown that in 90 per cent of the cases headache is basically due to mental tension or stress.

Stress may cause headache directly. In a study, patients getting headaches more frequently were asked to write down all the probable situations at diffe­rent times that brought on the attack. It was found out that all these had a common denominator: unpleasant situation to face. This was confirmed when these patients were faced with an unpleasant situation not mentioned by them. It duly brought on an attack of headache.

Mental stress can indirectly also cause headache through the agency of the spasm created in the muscles of the neck and the head. Driving and reading usually do not cause spasm of the muscles, but in people more inclined to mental stress, it does so. This has been recorded experimentally, as spasm in the muscles creat­ed by any factor can be measured accurately. In such people, the- amount of muscle spasm produced was proportional to the severity of the headache that they got.

In a case of headache, it is not the brain that is involved; it is entirely insensitive to the sensations of pain. It is the structures around the brain, particularly the blood vessels that are affected. Mental stress in some people leads to dilatation of the blood vessels which can sometimes be felt throbbing. In cases where muscle spasm is the intermediary factor, it is the cons­triction of the vessels with squeezing out of the blood from them that causes headache. We thus see that in one situation, it is the dilatation of vessels, while in the other, it is their constriction that leads to headache. This is indicative of the fact that still we know very little about the mechanism of the production of headache.

Then there is the migraine, the headache that effects one side of the head only. This, if severe, is accompani­ed with nausea, vomiting and even visual changes during the attack. Migraine is known to occur in peo­ple who by nature are intelligent, educated, compulsive, perfectionist, and ambitious-the type' who ate more prone to mental stress.

In order to help the patients who are prone to .headache, there are two courses of action that can be taken: (1) short-term measures to provide relief from the attack, and (2) long-term measures to lessen the frequency and intensity of attacks, or ideally, to try that the patient gets rid of such attacks,

Care with Aspirin

In order to provide relief from headache, aspirin is still considered to be the drug of choice. How it achieves its results is not known with any certainty but it does help in the majority of the cases. The drawbacks in resort­ing to frequent taking of aspirin are: (1) stomach upsets and ulcers that lead to minute hemorrhages from the stomach lining, (2) consequent loss of blood, and anemia, (3) the sensitivity to aspirin wherein the patients may get symptoms akin to asthma, or may get urticarial rashes.

When aspirin has to be taken, it should be taken crushed with milk, and not with water and it should not be taken on an empty stomach, as it is liable to upset the stomach very much.

It has been found that an analgesic like aspirin it given along with a sedative or a tranquillizer, provides better relief in a larger percentage of cases. So a com­bination of them can be given in order to relieve head­ache, but this should be done only on the advice of a doctor.

Those who suffer frequent headache, themselves know as to what provides relief. To one it may be mas­sage of the head and neck, which by lessening spasm of the muscles, gives relief from headache. In another it may be a tight bandage around the head. An applica­tion of a counter-irritant balm may help. A cup of hot milk, tea or coffee may serve equally well. Rest is the most important thing and in many patients that is the only thing which provides relief.

As part of the long-term measure, the patient can be asked to note down all the factors or situations which he or she thinks bring on headache. Here also, some people may come up with the observation that they get headache after seeing a picture; after taking alcohol, constant exposure to an uncovered light while reading, or after plain hunger. All these situations may only be the accompanying factors of a stressful situa­tion which needs to be dealt with.

Patients who occasiona1ly get headache are advised not to expect perfection in everything from people around them. They should accept things, and not be bogged down by needless stress in day-to-day living.

Frequent headache in a person is a signal, telling him that he must mend his mental stress-producing habits, which if not done, may lead to more damaging diseases later on.