A Headache is defined as a pain in the head or upper neck. It is one of the most common locations of pain in the body and has many causes.
There are three major categories of headaches:
- primary headaches,
- secondary headaches, and
- cranial neuralgias, facial pain, and other headaches
1. Primary headaches
Primary headaches include migraine, tension, and cluster headaches, as well as a variety of other less common types of headache.
Tension headaches are the most common type of primary headache. Up to 90% of adults have had or will have tension headaches. Tension headaches occur more commonly among women than men.
[learn_more caption=” The pain symptoms of a tension headache are:”]
- The pain begins in the back of the head and upper neck and is described as a band-like tightness or pressure.
- Often is described as pressure encircling the head with the most intense pressure over the eyebrows.
- The pain usually is mild (not disabling) and bilateral (affecting both sides of the head).
- The pain is not associated with an aura (see below), nausea, vomiting, or sensitivity to light and sound.
- The pain occurs sporadically (infrequently and without a pattern) but can occur frequently and even daily in some people.
- The pain allows most people to function normally, despite the headache.
Migraine headaches are the second most common type of primary headache.. Migraine headaches affect children as well as adults. Before puberty, boys and girls are affected equally by migraine headaches, but after puberty, more women than men are affected. It is estimated that 6% of men and up to 18% of women will experience a migraine headache in their lifetime.
Migraine is a chronic condition with recurrent attacks.
[learn_more caption=” Most (but not all) migraine attacks are associated with headaches.”]
- Migraine headaches usually are described as an intense, throbbing or pounding pain that involves one temple. (Sometimes the pain is located in the forehead, around the eye, or at the back of the head).
- The pain usually is unilateral (on one side of the head), although about a third of the time the pain is bilateral (on both sides of the head).
- The unilateral headaches typically change sides from one attack to the next. (In fact, unilateral headaches that always occur on the same side should alert the doctor to consider a secondary headache, for example, one caused by a brain tumor).
- A migraine headache usually is aggravated by daily activities such as walking upstairs.
- Nausea, vomiting, diarrhea, facial pallor, cold hands, cold feet, and sensitivity to light and sound commonly accompany migraine headaches. As a result of this sensitivity to light and sound, migraine sufferers usually prefer to lie in a quiet, dark room during an attack. A typical attack lasts between 4 and 72 hours. An estimated 40%-60% of migraine attacks are preceded by premonitory (warning) symptoms lasting hours to days. The symptoms may include:
- Depression or euphoria,
- Yawning, and
- Cravings for sweet or salty foods.
Patients and their family members usually know that when they observe these warning symptoms that a migraine attack is beginning.
Cluster headaches are a rare type of primary headache affecting 1 in a 1,000 people. It more commonly affects men in their late 20s though women and children can also suffer these types of headache.
The cause of cluster headaches is uncertain. It may be that certain parts of the brain begin to malfunction for an unknown reason. The hypothalamus, an area located at the base of the brain is responsible for the body’s biologic clock and may be the part of the brain that is the source for the headaches. Cluster headaches are headaches that come in groups (clusters) lasting weeks or months, separated by pain-free periods of months or years.
[learn_more caption=” Cluster headaches symptoms”]
- During the period in which the cluster headaches occur, pain typically occurs once or twice daily, but some patients may experience pain more than twice daily.
- Each episode of pain lasts from 30 to 90 minutes.
- Attacks tend to occur at about the same time every day and often awaken the patient at night from a sound sleep.
- The pain typically is excruciating and located around or behind one eye.
- Some patients describe the pain as feeling like a hot poker in the eye. The affected eye may become red, inflamed, and watery.
- The nose on the affected side may become congested and runny. Unlike patients with migraine headaches, patients with cluster headaches tend to be restless. They often pace the floor, bang their heads against a wall, and can be driven to desperate measures. Cluster headaches are much more common in men than women. Cluster headaches also:
- Tend to run in families and this suggests that there may be a genetic role;
- May be triggered by changes in sleep patterns;
- May be triggered by medications (for example, nitroglycerin, used for heart disease).
2. Secondary headaches:
Secondary headaches are those that are due to an underlying structural problem in the head or neck. There are numerous causes of this type of headache ranging from bleeding in the brain, tumor, or meningitis and encephalitis.
Secondary headaches can have such a wide array of causes that patients should seek information from a professional.