By Prof.Dr. Rao Suhail Yasin Khan – Consultant Neurologist, Advanced International Hospital

The Fear That Brings People to My Clinic

• “Doctor, my head feels like it’s going to explode.”
• “It hurts so much I can’t open my eyes or get out of bed.”
• These are real words from real patients suffering from headaches and migraines.
• It’s not “just a headache” when it starts affecting your life, work, sleep, and emotions.
• The worst part? People suffer in silence, assuming pain is something they must live with.

Understanding the Basics

• A headache is any pain in the head or neck region.
• A migraine is a specific type of headache – more severe, recurrent, and often with other symptoms.
• Not all headaches are migraines, but all migraines are headaches.
• Migraines are often genetic and triggered by lifestyle and environmental factors.

Types of Headaches

• Tension Headaches – dull, aching, pressure-type pain around the forehead or back of head.
• Migraine Headaches – throbbing, one-sided, often with nausea, sensitivity to light/sound.
• Cluster Headaches – excruciating pain around one eye, occurs in bouts or “clusters”.
• Sinus Headaches – facial pain with nasal congestion, especially with sinus infections.
• Secondary Headaches – due to an underlying problem like tumor, bleeding, or infection.

Symptoms That Should Never Be Ignored

• Headache that wakes you up at night.

• Sudden, explosive headache (“worst headache of my life”).
• Pain with blurred vision, confusion, weakness, or seizures.
• Headaches that worsen over time or don’t respond to usual medications.
• Headaches with fever, neck stiffness, or rash – may indicate meningitis.

Migraines – A Vicious Cycle

• Migraines usually begin in adolescence or early adulthood.
• Episodes can last from 4 to 72 hours if untreated.
• Many sufferers experience an “aura” – flashing lights, blind spots, or tingling.
• Migraine attacks often include nausea, vomiting, and extreme fatigue.
• Women are 3 times more likely to get migraines due to hormonal changes.

What Triggers Migraines?

• Stress and anxiety
• Sleep deprivation or oversleeping
• Skipped meals or dehydration
• Bright lights, loud sounds, or strong smells
• Weather changes
• Certain foods – chocolate, cheese, MSG, caffeine, alcohol
• Hormonal shifts – especially around menstruation

The Neurological Connection

• Migraines aren’t “just in your head”—they’re a neurovascular event.
• Brain chemicals (like serotonin) and nerve pathways are involved.
• Some people have a genetic predisposition, which makes their brain more “sensitive”.

When to See a Neurologist

• Chronic headaches affecting your daily life
• Neurological symptoms like vision loss, weakness, or imbalance
• Headaches unresponsive to standard treatment
• Suspicion of brain pathology – tumor, bleeding, or aneurysm

Diagnosis & Workup

• Detailed headache history & pattern analysis
• Neurological examination
• MRI or CT brain to rule out serious conditions
• Blood tests for inflammation or infections
• Eye exam for papilledema (optic nerve swelling)

Treatment Options

• Lifestyle changes – hydration, sleep hygiene, stress control
• Rescue medications – triptans, NSAIDs, anti-nausea drugs
• Preventive medications – beta-blockers, antidepressants, anti-epileptics
• Botox injections for chronic migraine
• Nerve blocks in resistant cases
• Surgery only if indicated – such as for tumors or vascular causes

24/7 Specialized Neuro & Headache Management

• 24/7 Neurosurgical evaluation by experienced specialists
• State-of-the-art imaging (MRI, CT, neuro-monitoring)
• Dedicated neurology and headache management protocols
• Multidisciplinary care – neurosurgery, internal medicine, ENT & psychology

My Advice to Patients

• Don’t ignore repeated headaches. Pain is your body’s way of asking for help.
• Keep a headache diary – track food, sleep, emotions, and attacks.
• Avoid triggers once you identify them.
• Seek help early – the longer migraines go untreated, the harder they become to control.
• Believe yourself – just because others can’t see the pain doesn’t mean it’s not real.

📞 Appointments & Contact

Prof. Dr. Rao Suhail Yasin Khan

📍 Advanced International Hospital, Islamabad
📞 051-111-786-005
🌐 www.aih.com.pk