Answer

It depends on (1) severity of the headache, and (2) what diagnosis and treatment options you have tried in the past. When primary care providers deem the headache to be too severe for the diagnosis and treatment options they have available, they will typically refer you to a neurologist. Severe headaches are often accompanied by nausea, vomiting, dizziness, loss of consciousness and blurred vision. They can be deemed to be serious based on their high frequency of occurrence, or their traumatic cause. If your primary care provider has tried to treat you over an extended period without success, that can also trigger a neurologist referral, particularly if symptoms worsen. Your insurance plan may require you to see your primary care provider for a referral before visiting a neurologist. As specialists in the diagnosis and treatment of diseases of the brain and nervous system, neurologists are able to effectively diagnose and treat various types of headaches.

Diagnosis

Neurologists mainly rely on self-reported symptoms, blood and urine tests, and diagnostic imaging (CT, MRI) to determine the cause of headaches. A necessary part of this process is ruling out diseases, such as tumors, infections, and injuries. Headaches can have multiple causes related to the function of the muscular, circulatory and/or nervous systems of the body. Though identifying the underlying cause is helpful for optimal treatment, it is not always possible or necessary for many pain management programs.

Treatment

Headache treatments are used for (1) prevention and (2) pain mitigation. Depending on the type of headache and accompanying symptoms, the neurologist may prescribe medications, counseling, behavioral modifications, or stress management.

Recommendations for Patients

Know your headache. Before visiting a physician, be prepared to describe your symptoms. The physician will want to know where on the head and neck the headaches are occurring, what they feel like, their frequency of occurrence, and information about any other symptoms that accompany the headaches, such as nausea. It is also important to know your medical history, particularly if there is anything in your past (such as a head injury), or anything in your family medical history that may help to explain the headaches. Keeping a diary that describes each headache occurrence can be very helpful.

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Answer

Yes, you likely can reduce your risk of acquiring brain disease. Note that certain diseases of the brain are related to clearly avoidable causes, such as head injuries and recreational drug use. Avoiding these dangers will certainly reduce your risk. Furthermore, a 2015 study in Finland showed that a 2-year-long intervention on the elderly that included a special diet, prescribed exercise, cognitive training, and vascular risk monitoring significantly reduced the loss of a variety of cognitive functions.(1) Studies like this show that your chance of developing brain disease can go down with a few behavioral modifications.

On the other hand, you can’t alter genetically inherited traits that may lead to brain disease later in life. Moreover, science is continually evolving and can’t tell you everything you need to know to be perfectly healthy.

What Can Be Done

Research on the causes and prevention of brain diseases is ongoing, but based on what we currently know, we can make the following recommendations:

First, take care of your physical health. Inadequate nutrition and exercise can absolutely negatively impact your cognitive functions. A simple way to improve one’s diet is to switch from white flour to whole grains. Incorporating fresh fruits and vegetables into every meal is another positive step. Please see the World Health Organization’s Nutrition Guidelines for more insights into what you can do to improve your diet. The U.S. Center for Disease Control has a variety of helpful resources for those wanting to engage in an exercise program:

• Physical Activity Guidelines

• Physical activity for older adults

Second, seek to improve your relationships. Every human being has a fundamental need to belong.(2) Research has shown that meaningful human interaction can reduce the risk of brain disease.(3) We suggest volunteering in your community, reconnecting with old friends, inviting someone to dinner, and patching up any damaged relationships with family members.

Third, stay active and have a purpose. There is some research showing that physical inactivity can lead to negative effects on the brain.(4) We recommend working or volunteering if you are able — even if you don’t financially need to. Fill your life with activity and meaning. Have something to look forward to each day.

Read more information about the prevention of Alzheimer's and other brain diseases at alz.org: 10 Ways to Love Your Brain.

Notes

1. Ngandu, Tiia, Jenni Lehtisalo, Alina Solomon, Esko Levälahti, Satu Ahtiluoto, Riitta Antikainen, Lars Bäckman et al. “A 2 year multidomain intervention of diet, exercise, cognitive training, and vascular risk monitoring versus control to prevent cognitive decline in at-risk elderly people (FINGER): a randomised controlled trial.” The Lancet 385, no. 9984 (2015): 2255-2263.

2. Leary, Mark R., and Roy F. Baumeister. “The need to belong: Desire for interpersonal attachments as a fundamental human motivation.” In Interpersonal Development, pp. 57-89. Routledge, 2017.

3. Hikichi, Hiroyuki, Katsunori Kondo, Tokunori Takeda, and Ichiro Kawachi. “Social interaction and cognitive decline: Results of a 7-year community intervention.” Alzheimer’s & Dementia: Translational Research & Clinical Interventions 3, no. 1 (2017): 23-32.

4. Siddarth, Prabha, Alison C. Burggren, Harris A. Eyre, Gary W. Small, and David A. Merrill. “Sedentary behavior associated with reduced medial temporal lobe thickness in middle-aged and older adults.” PloS one 13, no. 4 (2018): e0195549.

Normal brain (left) and brain affected with Alzheimer’s disease (right). Credit: Wikimedia Commons

Answer

The first sign of Alzheimer’s disease is typically memory loss. While it is common for people to forget a few things, but remember them later, memory loss associated with Alzheimer’s is more severe. It can disrupt daily life and make it difficult for someone who suffers from it to carry on a normal conversation. Alzheimer’s victims find they have to start relying more on family members and tools such as notes and electronic devices to keep track of things. The Alzheimer’s Association lays out a list of 10 signs to be used for early detection of Alzheimer’s disease.

What is Alzheimer's?

Alzheimer’s disease is a brain disorder that leads to decreased mental functioning over time. There is no known cure for Alzheimer’s and the causes are not well understood by science. Alzheimer’s disease typically strikes individuals in their mid-60s, but it can sometimes manifest when people are in their 30s or 40s. It affects the parts of the brain that control thought, memory and language. Alzheimer’s is a debilitating disease that prevents its victims from continuing to lead a normal life.

Next Steps

If you believe you or a family member may be suffering from Alzheimer’s disease, the first step is diagnosis. Talk to your doctor about the symptoms and see whether a visit with a neurologist is necessary. While there is no known cure, medical professionals can offer help in the form of (1) helping people maintain mental function, (2) managing behavioral symptoms, and (3) slowing or delaying the symptoms of Alzheimer’s.

Request An Appointment

If you are experiencing any symptoms that are related to your brain, nerves, or muscles, it may be a good idea to see a neurologist. Some common symptoms that may indicate the need to see a neurologist include headaches, seizures, weakness or numbness in your limbs, difficulty with balance or coordination, speech problems, or changes in your vision. It is always best to talk to your primary care doctor first, who can help determine if you need to see a neurologist or another type of healthcare provider.

If you think you may need to see a neurologist, the first step is to talk to your primary care doctor. They can evaluate your symptoms and determine if a referral to a neurologist is necessary. This referral will include any necessary information about your medical history and current symptoms, which will help the neurologist provide the best care possible. If you have any questions about the referral process, you can also contact the neurologist's office directly for more information.