By Henrylito D. Tacio
On May 3, 2002, 37-year-old Emma Salle and her three Filipino friends – all from Metro Manila — went to the nature-laden Baguio for relaxation and to know what was currently going on with their lives. The following day, they meandered around the city and visited some tourist spots before returning to their hotel at 9:00 p.m.
At around 10:00 pm, Emma took a shower. “I was in the middle of my shower when I felt something terrible in my head,” she recalls. “It was as if somebody was cutting my head from the upper middle of my forehead going down sideways to my nape — something I have never ever felt before in my entire life.”
While she was trying to make sense of what was happening, she kept on tilting her head from one side to another and up and down hoping to ease the pain. Then, she remembered her aunt who died of an appalling headache while taking a meal. That spurred her into action. She immediately finished her shower and came out as fast as she could from the bathroom. She told her friends that she was experiencing a terrible headache.
“I went straight to bed and kept on touching my head not knowing what to do,” she says. An hour later, the pain was getting worse. She would throw up every now and then. Her friends decided to bring her to Baguio General Hospital. A resident doctor asked her some questions but Emma could not answer. “My head never stopped hurting me – it was as if a huge bomb was exploding inside my head. I got really very weak and didn’t know what to do to stop the pain,” she says.
After some tests, the doctor found out that Emma’s blood pressure was high. She was given some medicines and four hours later, she felt better. She went to sleep and was discharged at 2:00 a.m. They returned to their hotel and checked-out that day.
Back home, when her family heard about the news, Emma was brought again to the hospital at 10:00 p.m. The doctor at the Makati Medical Center took some tests. At 5:00 a.m. the following day, Emma underwent a CT scan. After that, she was brought to a private room. “Although I still didn’t know what was happening, I had a suspicion that there was really something wrong,” she says.
There was. The doctor’s diagnosis: brain aneurysm. In fact, an artery in her left brain burst causing severe headache. But thanks to her doctors, she was saved from death giving her a new lease of life.
Headache is a disorder that afflicts millions of people across Asia. “Like in other parts of the world, headache is very common in the region,” says Dr Shuu-Jiun Wang, a neurologist with the Taipei Veterans General Hospital in Taiwan who specializes on headache medicine. “It’s a very rare person who has never experienced a headache.”
In Thailand, almost half of those polled in the online health survey conducted by The Nielsen Company claimed to have suffered a headache within the last month. About 30-40 percent of people in Taiwan suffer from tension-type headaches. In Singapore, migraine afflicts 360,000 people.
More than 300 known medical disorders can produce headaches. Headache types are described as primary or secondary. Primary headaches include migraine, tension-type and cluster headaches. If you’ve had the same pattern of headaches for years, chances are that it’s going to continue that way for years more.
Often a headache is just a pain the head but if your headache is so severe that you miss work or social gatherings, or if over-the-counter painkillers don’t help, see your doctor. The headache you may be suffering from might be classified under the secondary headaches or those that are often the result of some underlying disease, of which head pain is just a symptom.
“Those severe and sudden headaches could be a symptom of something more serious that needs immediate medical attention,” says Dr Delfin Valdez, head of the emergency room at the Brokenshire Memorial Hospital in Davao City, Philippines.
Here, according to Asian health experts, are life-threatening diseases of which headache is almost always the first thing that most people complain about:
Brain aneurysm. If a brain aneurysm bursts, as in the case of Emma Salle, it causes instantaneous onset of an unusually severe headache, says Dr Philip Chua, chairman of the cardiovascular surgery centre at the Cebu Doctors’ Hospital in the central Philippines. Other symptoms include nausea and vomiting, blurred vision, pain above and behind the eye and stiff neck.
Brain aneurysms are deadly. About 10 percent of patients with ruptured aneurysm die before receiving medical treatment. (Martial arts movie star Bruce Lee is thought to have died from a brain aneurysm.) If untreated, another 50 percent will die within a month, with 25 percent of the patients sustaining another bleeding episode within a week. Dr Chua suggests that aneurysms be removed immediately before they burst.
Dr Alfred Cheng, head of the cardiac clinic at the Mount Elizabeth Medical Centre in Singapore offers two pieces of advice: If you suspect a burst, go to a vascular neurosurgeon immediately. “Quick surgery can save a person’s life,” he says. Second, if you are at risk for having an aneurysm – if you smoke, have high blood pressure and high cholesterol – ask your doctor to do an MRI screening.
Brain tumor. Often, tumors found in the brain have started somewhere else in the body and spread to the brain. New onset or change in pattern of headaches is one of the initial signs. The headache gradually becomes more frequent and more severe. Other symptoms include blurred vision, difficulty with balance, speech difficulties, confusion in everyday matters, personality or behavior changes, hearing problems, and seizures (especially in someone who doesn’t have a history of seizures).
Brain tumors are often challenging for doctors to treat. But many types of brain tumors can be successfully treated with one or more methods. In the United States, some approved treatments for brain tumors include BCNU, Temodar, Gliadel wafers, and radiation. While these approved treatments are considered safe, it does not mean there are no side effects. On the whole, the benefits to brain tumor patients outways the risks.
Glaucoma. The headache caused by glaucoma may be felt in or around the eyes or the forehead, and vary in intensity from mild to severe. Accompanying the headache is nausea, blurred vision, and haloes around lights.
Glaucoma is a condition of increased fluid pressure inside the eye. The higher pressure causes compression of the retina and the optic nerve, which can eventually lead to nerve damage, interfering with or stopping images as they are transmitted from the eye to the brain. “The headache is due to a sudden increase of eye pressure,” says Dr Gerard Chuah, a senior consultant ophthalmologist at the Mount Elizabeth Medical Centre in Singapore.
There are two types of glaucoma: chronic and acute. Although the latter accounts for only about five percent of all cases worldwide, studies indicate that Asians are more susceptible to it. Eye drops, oral medications, and surgical procedures can prevent or slow further damage. “Acute glaucoma should be treated as an emergency,” says Dr Mimiwati Zahari of the ophthalmology department at the University of Malaya in Kuala Lumpur, Malaysia. “If not treated immediately, it can result in complete and permanent blindness within one to five days,” warns Dr Tony Ho, the director of Clearvision Eye Clinic in Singapore.
Hypertension. Although hypertension itself doesn’t kill, its complications can be deadly: increased risk of heart attack, stroke and kidney failure. The condition is caused by an increase in the amount of blood pumped by the heart or an increased resistance to blood as it flows through the arteries. “A person suffers from hypertension when their blood pressure is persistently elevated beyond a normal level,” says Dr Willie Ong, a consultant cardiologist at the Makati Medical Center.
More often than not, people suffering from hypertension don’t usually see or feel any clearly identifiable symptoms. But if blood pressure is extremely high, severe headache ensues. “Patients complain of heaviness or uneasy feeling around the nape area,” says Dr Ong. Other symptoms include fatigue or confusion, vision problems, chest pain, irregular heartbeat, and difficulty breathing.
Unfortunately, there is no cure for hypertension, but it can be managed. “Mild cases of hypertension may still respond with a change in lifestyle,” says Dr Ong. Unhealthy lifestyles include smoking, drinking too much alcohol or coffee, and eating too much salt. “But for more severe cases, medication is for life. Even if your blood pressure has been returned to normal, it’s important to continue to take the medications.”
Stroke. A stroke, also known as brain attack, occurs when a blood vessel breaks and interrupts blood flow to an area of the brain (called cerebral hemorrhage) or when a blood clot blocks a blood vessel or artery (cerebral infarction). Almost always, cerebral hemorrhage patients experience a sudden, severe “bolt out of the blue” headache, which may be accompanied by a stiff neck, facial pain, pain between the eyes, vomiting, confusion, and unusual forgetfulness. “When any of these symptoms occur, the best course is a quick trip to the doctor,” says Dr Rafael Castillo, a cardiologist at Manila Doctors’ Hospital.
What’s tricky with stroke is that symptoms of the disease may be momentary, but they are a warning that must be acted on promptly. Among the early signs are: numbness, tingling or weakness in an arm, leg or side of the face; temporary blindness; temporary speech difficulty; and dizziness, unsteadiness or sudden falls. “Ignoring these signs and not getting to a hospital immediately could make a serious problem even worse,” reminds Dr Castillo.
Preventing a stroke is much better than treating it. Most physicians recommend the following: Get screened for high blood pressure at least every two years, especially if you have a family history of high blood pressure. Have your cholesterol checked. Treat high blood pressure, diabetes, high cholesterol, and heart disease if present. Follow a diet low in fat and salt. Quit smoking. Exercise regularly. Lose weight if you are overweight. Avoid excessive alcohol use. — ###