Dear Doctor,

I have constant on and off headache. I have no previous history of an accident, but I have been advised to go for a CT scan. Is this normal?

Musa Rwamagana

Dear Musa,

Headache can be a result of many reasons. You have not specified how long you have been having the headache, the part that pains you on the head or if there are any associated colds, visual problems, toothaches and high blood pressure, to mention but a few. Is the headache associated with nausea and or vomiting? Does it come at a fixed time during day or night?

A person can have headache due to any of these problems. The type of headache depends on the cause. For example, recurrent cold can cause the head to ache on the front or on both sides. The headache will also be pulsatile more in the morning and is increased by looking down due to a cold. Visual problems can cause dull to severe headache, which is increased after eye strain like working on a computer for long time.

Headache can also occur without any underlying pathology, simply due to mental stress. Migraine and tension headache are such types of headache. A CT scan shows the brain in a three-dimensional picture. It is usually asked for to exclude any pathology or confirm a suspected pathology of the brain. If a person has unexplained headache and all other tests are normal, a CT scan can be asked for to see any hidden pathology in the brain.

Dr Rachna Pande  is a specialist in internal medicine at Ruhengeri Hospital