Ask the expert: Headaches

Susannah Hickling

We all suffer from headaches from time to time, but when do they become a cause for concern? We asked Sanj Bassi, a consultant neurosurgeon at King’s College Hospital, London and The Harley Street Clinic, for his advice.

What led you to become a neurosurgeon?

When I was training I found the brain fascinating and the thought of being a brain surgeon seemed cool.

Having started neurosurgery, the excitement and passion continued as I began to realise what could be achieved and how much there was still to learn. 

 

What are the causes of most headaches?

A lot of headaches will be caused by stress, tension or migraines, or if you’re a bit dehydrated or have a hangover. These things are common and most headaches aren’t sinister.

 

What can people do to prevent or ease them?

Some of it may be simple lifestyle things. For example, to prevent a hangover, have lots of water when you get home. For stress and tension, look at mindfulness.

Simple painkillers will ease headaches but migraines need to be treated very specifically with anti-migraine medication, so getting a diagnosis for migraine is reasonable. 

 

Why are some people more prone to headaches?

There will be a set of patients who get migraines who probably have a genetic predisposition. There is significant psychology around pain. Some people who get headaches may carry on regardless, while others struggle.

People in certain occupations requiring hours of concentration may find it harder to manage than others.

 

When should someone be worried about a headache?

If someone’s been previously well, and then suffers a new onset of a sudden severe headache, almost as if someone has hit you on the head, that needs immediate investigation. That can be due to a bleed in the brain.

With headaches that come on for the first time that are persistent, troublesome, not settling with simple paracetamol, then it’s worth getting an opinion.

Then you’ve got patients who get early morning headaches daily, nausea and vomiting, their vision’s not quite right—again those patients should be seen. In older age groups, any new symptoms are a red flag, but most headaches are innocuous.

 

Mr Sanj Bassi is a consultant neurosurgeon at London Neurosurgery Partnership at The Harley Street Clinic (part of HCA Healthcare UK) and King's College Hospital, London. 

For more information, please visit lnpuk.com

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