I get headaches about five times a month, could it be a brain tumour?

I am a 15-year-old girl and I have headaches about five times a month. Could I have a brain tumour? What should I do?

Headaches often make us worry that there is something seriously wrong. Fortunately, almost all headaches are not because of serious disease. However, a physician should check out any young person with strong or frequent headaches.

Many family doctors are experienced enough to do a careful and thorough history and neurological exam. If needed (and it often isn’t) a referral to a pediatrician or a neurologist may occur.

Specialists may order tests such as an MRI (Magnetic Resonance Imaging) test, an EEG (electro encephalogram) or a CAT (Computed Axial Tomography) Scan. However, tests are only done if there is a good reason.

Most headaches are either tension headaches or migraine headaches. Tension headaches cause mild or moderate pain. They often feel like tightness around the head. They are not made worse with exercise and don’t pound really hard.

Migraine headaches with aura include a change in what you see a half hour before the pain begins. The changes can be a hole in the vision or a series of lines like a many-pointed star. The problem is not in the eyes but in the vision part of the brain. The aura goes away in a half hour. Some migraines do not have an aura. Sometimes people have auras and no pain, but may have a heavy feeling in their head.

Migraines often cause severe pain. There may be nausea (a feeling like you are going to throw up) or vomiting. Many find light or noise very uncomfortable when they have migraines. Migraines are often made worse by activity.

Treatment should follow a stepwise method. The first step is to figure out the trigger of headache and remove it. For example, skipping a meal causes some headaches. Bright sunlight triggers others. Stress might cause headaches, too. Drinking alcohol, lack of sleep, or even cigarette smoking can be triggers. The solutions are obvious but not easy.

The second step is over-the-counter medication. The most common drugs are analgesics. Ibuprofen (Advil® or Motrin®) may be a bit more effective than acetaminophen (Tylenol®). However, ibuprofen is hard on the stomach and should be taken with food.
Some over-the-counter medicines are specially formulated for headache. They might be more useful. Generic or house brands are cheaper and just as good as the name brands.
Take the drug as soon as the headache begins. Waiting till the pain is unbearable will make it more difficult for the drug to work.

Don’t take more than the label says without consulting your doctor. Aspirin®, ASA or acetasylic acid is not used with children or adolescents because it has been associated with Reye’s syndrome, a severe liver disease.

The third step includes either stress management therapy or prescription medication. Many psychologists can help you with stress management therapy. You will learn how to relax your body and control your thinking.

Prescription medication for migraine is also used. These can be very effective. Sometimes hormones such as birth control pills are prescribed. Talk with your doctor. Headaches can make your life miserable. You don’t have to put up with them. You can get help.

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