What are the most common types of headaches. How can you identify different headache symptoms. What causes various headaches. How are headaches diagnosed and treated. What should you expect after starting headache treatment.

Understanding Different Types of Headaches

Headaches are a common ailment that can significantly impact daily life. With over 150 types identified, it’s crucial to understand the distinctions between them for proper management and treatment. Let’s explore the most prevalent headache types and their unique characteristics.

Tension Headaches: The Most Common Culprit

Tension headaches are the most frequently experienced type among adults and teenagers. They typically cause mild to moderate pain and occur intermittently over time. What sets tension headaches apart from other types? Generally, they lack additional symptoms beyond the head pain itself.

Migraine Headaches: More Than Just Pain

Migraines are often described as a pounding or throbbing sensation. How long do migraines typically last? These headaches can persist anywhere from 4 hours to 3 days and usually occur one to four times per month. Migraines are characterized by additional symptoms, including:

• Sensitivity to light, noise, or smells
• Nausea or vomiting
• Loss of appetite
• Upset stomach or abdominal pain

In children, migraines may manifest differently. Can children experience migraines? Yes, and they may present with symptoms such as pallor, dizziness, blurred vision, fever, and stomach discomfort. Some children even experience periodic digestive symptoms, like vomiting, about once a month.

Cluster Headaches: Intense and Cyclical

Cluster headaches are known for their severity and distinct pattern. What makes cluster headaches unique? These headaches are characterized by intense burning or piercing pain, typically localized behind or around one eye. The pain can be so severe that individuals often find it difficult to remain still during an attack.

Additional symptoms of cluster headaches may include:

• Drooping eyelid on the affected side
• Redness in the eye
• Constricted pupil
• Tearing
• Runny or stuffy nostril on the affected side

Why are they called cluster headaches? These headaches tend to occur in groups or clusters, with sufferers experiencing one to three attacks per day during a cluster period. These periods can last from 2 weeks to 3 months, followed by periods of remission.

Chronic Daily Headaches: When Pain Becomes Persistent

Chronic daily headaches are defined by their frequency and duration. How often do chronic daily headaches occur? To be classified as chronic, headaches must occur 15 days or more per month for longer than 3 months. These headaches can be further categorized into four primary types:

1. Chronic migraine
2. Chronic tension headache
3. New daily persistent headache
4. Hemicrania continua

Less Common Headache Types: Sinus, Posttraumatic, and Exercise-Induced

Sinus Headaches: When Inflammation Strikes

Sinus headaches are characterized by a deep, constant pain in the cheekbones, forehead, or bridge of the nose. What causes sinus headaches? These headaches result from inflammation in the sinus cavities and are often accompanied by other sinus-related symptoms such as:

• Runny nose
• Fullness in the ears
• Fever
• Facial swelling

It’s important to note that true sinus headaches are caused by sinus infections, resulting in yellow or green nasal discharge, unlike the clear discharge seen in cluster or migraine headaches.

Posttraumatic Headaches: The Aftermath of Head Injury

Posttraumatic headaches typically begin 2-3 days following a head injury. What are the symptoms of posttraumatic headaches? Common symptoms include:

• A dull ache that intensifies over time
• Vertigo
• Lightheadedness
• Difficulty concentrating
• Memory problems
• Increased fatigue
• Irritability

While these headaches may persist for several months, it’s advisable to consult a doctor if symptoms don’t improve within a couple of weeks.

Exercise Headaches: When Physical Activity Triggers Pain

Exercise headaches occur during or immediately after physical activity. Why do exercise headaches happen? During exercise, the muscles in the head, neck, and scalp require increased blood flow, causing blood vessels to swell. This results in a pulsing pain on both sides of the head, lasting anywhere from 5 minutes to 48 hours.

Rare Headache Types: Hemicrania Continua and Hormone Headaches

Hemicrania Continua: Persistent One-Sided Pain

Hemicrania continua is a chronic headache that almost always affects the same side of the face and head. What are the characteristics of hemicrania continua? Key features include:

• Pain that varies in severity
• Red or teary eye on the affected side
• Runny or stuffy nose
• Droopy eyelid
• Contracted iris
• Response to the pain medication indomethacin
• Worsening pain with physical activity or alcohol consumption

Some individuals may also experience migraine-like symptoms such as nausea, vomiting, and sensitivity to light and sound.

Hormone Headaches: The Impact of Fluctuating Hormones

Hormone headaches can occur due to shifting hormone levels during various life stages and events. When do hormone headaches typically occur? These headaches may be triggered during:

• Menstrual periods
• Pregnancy
• Menopause

Additionally, hormone changes resulting from birth control pills and hormone replacement therapy can also lead to headaches. When these headaches occur 2 days before menstruation or within the first 3 days of its onset, they are classified as menstrual migraines.

Identifying the Underlying Causes of Headaches

Understanding the root causes of headaches is crucial for effective management and treatment. What factors contribute to the development of headaches? Common causes include:

• Stress and tension
• Dehydration
• Lack of sleep or changes in sleep patterns
• Certain foods or food additives
• Alcohol consumption
• Caffeine withdrawal
• Changes in weather or barometric pressure
• Hormonal fluctuations
• Underlying medical conditions

It’s important to note that headache triggers can vary significantly from person to person. Keeping a headache diary can help identify personal triggers and patterns.

Diagnosing Headaches: The Path to Proper Treatment

Accurate diagnosis is essential for effective headache management. How are headaches typically diagnosed? The diagnostic process may involve:

1. Detailed medical history: Your doctor will ask about your symptoms, frequency of headaches, and potential triggers.
2. Physical examination: This may include a neurological exam to check for signs of underlying conditions.
3. Headache diary: Keeping track of your headaches can help identify patterns and triggers.
4. Imaging tests: In some cases, CT scans or MRIs may be ordered to rule out structural issues.
5. Blood tests: These can help identify potential underlying health conditions.

In some cases, your doctor may refer you to a neurologist or headache specialist for further evaluation and management.

Treatment Approaches for Various Headache Types

The treatment of headaches varies depending on the type, frequency, and severity of the condition. What are the common treatment approaches for headaches?

Over-the-Counter Medications

For mild to moderate headaches, over-the-counter pain relievers such as acetaminophen, ibuprofen, or aspirin may be sufficient. It’s important to use these medications as directed and be aware of potential side effects with long-term use.

Prescription Medications

For more severe or frequent headaches, prescription medications may be necessary. These can include:

• Triptans for migraines
• Preventive medications for chronic headaches
• Anticonvulsants for certain types of headaches
• Beta-blockers or calcium channel blockers for specific headache types

Lifestyle Modifications

Making changes to your daily habits can significantly impact headache frequency and severity. What lifestyle modifications can help manage headaches?

• Stress reduction techniques such as meditation or yoga
• Regular exercise
• Maintaining a consistent sleep schedule
• Staying hydrated
• Avoiding known triggers
• Practicing good posture

Alternative Therapies

Some individuals find relief through alternative therapies. These may include:

• Acupuncture
• Massage therapy
• Biofeedback
• Herbal supplements (under medical supervision)

What to Expect After Starting Headache Treatment

After initiating headache treatment, it’s important to monitor your progress and communicate with your healthcare provider. What should you expect after starting treatment?

• Gradual improvement: It may take time to see significant results, especially with preventive medications.
• Potential side effects: Be aware of possible side effects from medications and report them to your doctor.
• Adjustments to treatment plan: Your doctor may need to modify your treatment based on your response.
• Continued monitoring: Regular check-ups help ensure the effectiveness of your treatment plan.

Remember that finding the right treatment approach may require some trial and error. It’s essential to work closely with your healthcare provider to develop an effective management strategy tailored to your specific needs.

By understanding the various types of headaches, their causes, and available treatment options, individuals can take proactive steps towards managing their condition and improving their quality of life. If you experience frequent or severe headaches, don’t hesitate to seek medical advice for proper diagnosis and treatment.

Types, Causes, Symptoms, Diagnosis, Treatment

Written by WebMD Editorial Contributors

Medically Reviewed by Jennifer Robinson, MD on September 14, 2022

• Common Types of Headaches
• Less Common Headaches
• Rare Headaches
• What Causes Headaches?
• Getting a Diagnosis
• How Are Headaches Treated?
• What Happens After I Start Treatment?
• More

Headaches can be more complicated than most people realize. Different kinds can have their own set of symptoms, happen for unique reasons, and need different treatments.

Once you know the type of headache you have, you and your doctor can find the treatment that’s most likely to help and even try to prevent them.

There are over 150 types of headaches, but the most common types include:

Tension Headaches

Tension headaches are the most common type of headache among adults and teens. They cause mild to moderate pain and come and go over time. They usually have no other symptoms.

Migraine Headaches

Migraine headaches are often described as pounding, throbbing pain. They can last from 4 hours to 3 days and usually happen one to four times a month. Along with the pain, people have other symptoms, such as sensitivity to light, noise, or smells; nausea or vomiting; loss of appetite; and upset stomach or belly pain. When a child has a migraine, they may look pale, feel dizzy, and have blurry vision, fever, and an upset stomach. A small number of children’s migraines include digestive symptoms, like vomiting, that happen about once a month.

Cluster Headaches

These headaches are the most severe. You could have intense burning or piercing pain behind or around one eye. It can be throbbing or constant. The pain can be so bad that most people with cluster headaches can’t sit still and will often pace during an attack. On the side of the pain, the eyelid droops, the eye reddens, pupil gets smaller, or the eye makes tears. The nostril on that side runs or stuffs up.

They’re called cluster headaches because they tend to happen in groups. You might get them one to three times per day during a cluster period, which may last 2 weeks to 3 months. Each headache attack lasts 15 minutes to 3 hours. They can wake you up from sleep. The headaches may disappear completely (your doctor will call this remission) for months or years, only to come back later. Men are three to four times more likely to get them than women.

Chronic Daily Headaches

You have this type of headache 15 days or more a month for longer than 3 months. Some are short. Others last more than 4 hours. It’s usually one of the four types of primary headache:

• Chronic migraine
• Chronic tension headache
• New daily persistent headache
• Hemicrania continua

Sinus Headaches

With sinus headaches, you feel a deep and constant pain in your cheekbones, forehead, or on the bridge of your nose. They happen when cavities in your head, called sinuses, get inflamed. The pain usually comes along with other sinus symptoms, like a runny nose, fullness in the ears, fever, and a swollen face. A true sinus headache results from a sinus infection so the gunk that comes out of your nose will be yellow or green, unlike the clear discharge in cluster or migraine headaches.

Posttraumatic Headaches

Posttraumatic stress headaches usually start 2-3 days after a head injury. You’ll feel:

• A dull ache that gets worse from time to time
• Vertigo
• Lightheadedness
• Trouble concentrating
• Memory problems
• Tiring quickly
• Irritability

Headaches may last for a few months. But if it doesn’t get better within a couple of weeks, call your doctor.

Exercise Headaches

When you’re active, the muscles in your head, neck, and scalp need more blood. Your blood vessels swell to supply them. The result is a pulsing pain on both sides of your head that can last anywhere from 5 minutes to 48 hours. It usually hits while you’re active or just afterward, whether the activity is exercise or sex.

Hemicrania Continua

Hemicrania continua is a chronic, ongoing headache almost always affects the same side of your face and head. Other symptoms include:

• Pain that varies in severity
• Red or teary eyes
• Runny or stuffy nose
• Droopy eyelid
• Contracted iris
• Responds to the pain medication indomethacin
• Worse pain with physical activity
• Worse pain with drinking alcohol

Some people also notice migraine symptoms like:

• Nausea and vomiting
• Sensitivity to light and sound

There are two types:

• Chronic: You have daily headaches.
• Remitting: You have headaches for 6 months. They go away for a period of weeks or months and come back.

Hormone Headaches

You can get headaches from shifting hormone levels during your periods, pregnancy, and menopause. The hormone changes from birth control pills and hormone replacement therapy can also trigger headaches. When they happen 2 days before your period or in the first 3 days after it starts, they’re called menstrual migraines.

New Daily Persistent Headaches (NDPH)

These may start suddenly and can go on for 3 months or longer. Many people clearly remember the day their pain began.

Doctors aren’t sure why this type of headache starts. Some people find that it strikes after an infection, flu-like illness, surgery, or stressful event.

The pain tends to be moderate, but for some people, it’s severe. And it’s often hard to treat.

Symptoms can vary widely. Some are like tension headaches. Others share symptoms of migraine, such as nausea or sensitivity to light.

Call your doctor if your headache won’t go away or if it’s severe.

Rebound Headaches

You might also hear these called medication overuse headaches. If you use a prescription or over-the-counter pain reliever more than two or three times a week, or more than 10 days a month, you’re setting yourself up for more pain. When the meds wear off, the pain comes back and you have to take more to stop it. This can cause a dull, constant headache that’s often worse in the morning.

Ice Pick Headaches

These short, stabbing, intense headaches usually only last a few seconds. They might happen a few times a day at most. If you have one, see the doctor. Ice pick headaches can be a condition on their own, or they can be a symptom of something else.

Spinal Headaches

Talk to your doctor if you get a headache after you have a spinal tap, a spinal block, or an epidural. Your doctor might call it a puncture headache because these procedures involve piercing the membrane that surrounds your spinal cord. If spinal fluid leaks through the puncture site, it can cause a headache.

Thunderclap Headaches

People often call this the worst headache of your life. It comes suddenly out of nowhere and peaks quickly. Causes of thunderclap headaches include:

• Blood vessel tear, rupture, or blockage
• Head injury
• Hemorrhagic stroke from a ruptured blood vessel in your brain
• Ischemic stroke from a blocked blood vessel in your brain
• Narrowed blood vessels surrounding the brain
• Inflamed blood vessels
• Blood pressure changes in late pregnancy

Take a sudden new headache seriously. It’s often the only warning sign you get of a serious problem.

The pain you feel during a headache comes from a mix of signals between your brain, blood vessels, and nearby nerves. Specific nerves in your blood vessels and head muscles switch on and send pain signals to your brain. But it isn’t clear how these signals get turned on in the first place.

Common causes of headaches include:

• Illness. This can include infections, colds, and fevers. Headaches are also common with conditions like sinusitis (inflammation of the sinuses), a throat infection, or an ear infection. In some cases, headaches can result from a blow to the head or, rarely, a sign of a more serious medical problem.
• Stress. Emotional stress and depression as well as alcohol use, skipping meals, changes in sleep patterns, and taking too much medication. Other causes include neck or back strain due to poor posture.
• Your environment, including secondhand tobacco smoke, strong smells from household chemicals or perfumes, allergens, and certain foods. Stress, pollution, noise, lighting, and weather changes are other possible triggers.
• Genetics. Headaches, especially migraine headaches, tend to run in families. Most children and teens (90%) who have migraines have other family members who get them. When both parents have a history of migraines, there is a 70% chance their child will also have them. If only one parent has a history of these headaches, the risk drops to 25%-50%.

Doctors don’t know exactly what causes migraines. One theory suggest that a problem with the electric charge through nerve cells causes a sequence of changes that cause migraines.

Too much physical activity can also trigger a migraine in adults.

Once you get your headaches diagnosed correctly, you can start the right treatment plan for your symptoms.

The first step is to talk to your doctor about your headaches. They’ll give you a physical exam and ask you about the symptoms you have and how often they happen. It’s important to be as complete as possible with these descriptions. Give your doctor a list of things that cause your headaches, things that make them worse, and what helps you feel better. You can track details in a headache diary to help your doctor diagnose your problem.

Most people don’t need special diagnostic tests. But sometimes, doctors suggest a CT scan or MRI to look for problems inside your brain that might cause your headaches. Skull X-rays won’t help. An EEG (electroencephalogram) is also unnecessary unless you’ve passed out when you had a headache.

If your headache symptoms get worse or happen more often despite treatment, ask your doctor to refer you to a headache specialist.

Your doctor may recommend different types of treatment to try. They also might suggest more testing or refer you to a headache specialist.

The type of headache treatment you need will depend on a lot of things, including the type of headache you get, how often, and its cause. Some people don’t need medical help at all. But those who do might get medications, electronic medical devices, counseling, stress management, and biofeedback. Your doctor will make a treatment plan to meet your specific needs.

Once you start a treatment program, keep track of how well it’s working. A headache diary can help you note any patterns or changes in how you feel. Know that it may take some time for you and your doctor to find the best treatment plan, so try to be patient. Be honest with them about what is and isn’t working for you.

Even though you’re getting treatment, you should still steer clear of the things you know can trigger your headaches, like foods or smells. And it’s important to stick to healthy habits that will keep you feeling good, like regular exercise, enough sleep, and a healthy diet. Also, make your scheduled follow-up appointments so your doctor can see how you’re doing and make changes in the treatment program if you need them. 

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Headache Pain: When to Worry, What to Do – Harvard Health Publishing

Nearly everyone has had headache pain, and most of us have had it many times. A minor headache is little more than a nuisance that’s relieved by an over-the-counter pain reliever, some food or coffee, or a short rest. But if your headache is severe or unusual, you might worry about stroke, a tumor, or a blood clot. Fortunately, such problems are rare. Still, you should know when a headache needs urgent care and how to control the vast majority of headaches that are not threatening to your health.

What causes headaches?

Doctors don’t fully understand what causes most headaches. They do know that the brain tissue and the skull are never responsible since they don’t have nerves that register pain. But the blood vessels in the head and neck can signal pain, as can the tissues that surround the brain and some major nerves that originate in the brain. The scalp, sinuses, teeth, and muscles and joints of the neck can also cause head pain.

When to worry about a headache

You can take care of many types of headaches by yourself, and your doctor can give you medication to control most of the tougher headaches. But some headaches call for prompt medical care. Here are some warning signs for when you should worry about headaches:

• Headaches that first develop after age 50
• A major change in the pattern of your headaches
• An unusually severe headache
• Head pain that increases with coughing or movement
• Headaches that get steadily worse
• Changes in personality or mental function
• Headaches that are accompanied by fever, stiff neck, confusion, decreased alertness or memory, or neurological symptoms such as visual disturbances, slurred speech, weakness, numbness, or seizures
• Headaches that are accompanied by a painful red eye
• Headaches that are accompanied by pain and tenderness near the temples
• Headaches after a blow to the head
• Headaches that prevent normal daily activities
• Headaches that come on abruptly, especially if they wake you up
• Headaches in patients with cancer or impaired immune systems

Types of headaches

There are more than 300 types of headaches, but only about 10% of headaches have a known cause. The others are called primary headaches. Here is a rundown on some major primary headaches.

Tension headaches

Occurring in about three of every four adults, tension headaches are the most common of all headaches. In most cases, they are mild to moderate in severity and occur infrequently. But a few people get severe tension headaches, and some are troubled by them for three or four times a week.

The typical tension headache produces a dull, squeezing pain on both sides of the head. People with strong tension headaches may feel like their head is in a vise. The shoulders and neck can also ache. Some tension headaches are triggered by fatigue, emotional stress, or problems involving the muscles or joints of the neck or jaw. Most last for 20 minutes to two hours.

If you get occasional tension-type headaches, you can take care of them yourself. Over-the-counter pain relievers such as acetaminophen (Tylenol, other brands) and nonsteroidal anti-inflammatories (NSAIDs) such as aspirin, naproxen (Aleve, other brands), or ibuprofen (Motrin, Advil, other brands) often do the trick, but follow the directions on the label, and never take more than you should. A heating pad or warm shower may help; some people feel better with a short nap or light snack.

If you get frequent tension-type headaches, try to identify triggers so you can avoid them. Don’t get overtired or skip meals. Learn relaxation techniques; yoga is particularly helpful because it can relax both your mind and your neck muscles. If you clench your jaw or grind your teeth at night, a bite plate may help.

If you need more help, your doctor may prescribe a stronger pain medication or a muscle relaxant to control headache pain. Many people with recurrent tension-type headaches can prevent attacks by taking a tricyclic antidepressant such as amitriptyline (Elavil, generic). Fortunately, most people with tension-type headaches will do very well with simpler programs.

Migraine

Migraines occur less often than tension headaches, but they are usually much more severe. They are two to three times more common in women than men, but that’s small consolation if you are among the 6% to 8% of all men who have migraines. And since a Harvard study of 20,084 men age 40 to 84 reported that having migraines boosts the risk of heart attacks by 42%, men with migraines should take their headaches to heart.

Neurologists believe that migraines are caused by changes in the brain’s blood flow and nerve cell activity. Genetics play a role since 70% of migraine victims have at least one close relative with the problem.

Migraine triggers. Although a migraine can come on without warning, it is often set off by a trigger. The things that set off a migraine vary from person to person, but a migraine sufferer usually remains sensitive to the same triggers. The table lists some of the most common ones.

Migraine symptoms.  Migraines often begin in the evening or during sleep. In some people, the attacks are preceded by several hours of fatigue, depression, and sluggishness or by irritability and restlessness. Because migraine symptoms vary widely, at least half of all migraine sufferers think they have sinus or tension headaches, not migraines.

About 20% of migraines begin with one or more neurological symptoms called an aura. Visual complaints are most common. They may include halos, sparkles or flashing lights, wavy lines, and even temporary loss of vision. The aura may also produce numbness or tingling on one side of the body, especially the face or hand. Some patients develop aura symptoms without getting headaches; they often think they are having a stroke, not a migraine.

The majority of migraines develop without an aura. In typical cases, the pain is on one side of the head, often beginning around the eye and temple before spreading to the back of the head. The pain is frequently severe and is described as throbbing or pulsating. Nausea is common, and many migraine patients have a watering eye, a running nose, or congestion. If these symptoms are prominent, they may lead to a misdiagnosis of sinus headaches. One way to remember the features of migraine is to use the word POUND

P is for pulsating pain

O for one-day duration of severe untreated attacks

U for unilateral (one-sided) pain

N for nausea and vomiting

D for disabling intensity.

Without effective treatment, migraine attacks usually last for four to 24 hours. When you’re suffering a migraine, even four hours is far too long — and that’s why early treatment for a migraine is so important.

Migraine treatment. If you spot a migraine in its very earliest stages, you may be able to control it with nonprescription pain relievers. Acetaminophen, aspirin, ibuprofen, naproxen, and a combination of pain medications and caffeine are all effective — if you take a full dose very early in the attack.

When prescription drugs are needed, most doctors turn to the triptans, which are available as tablets, nasal sprays, or as injections that patients can learn to give to themselves. Examples include sumatriptan (Imitrex), zolmitriptan (Zomig), and rizatriptan (Maxalt). Triptans provide complete relief within two hours for up to 70% of patients; the response is best if treatment is started early. Some patients require a second dose within 12 to 24 hours. Patients with cardiovascular disease and those who take a high dose of certain antidepressants need to discuss the risks of using them with their doctor.

Work with your doctor to find the migraine treatment that works best for you. Remember, though, that overuse can lead to rebound headaches and a vicious cycle of drugs and headaches. So, if you need treatment more than two or three times a week, consider preventive medications.

Migraine prevention. Some people can prevent migraines simply by avoiding triggers. Others do well with prompt therapy for occasional attacks. But patients who suffer frequent migraine attacks often benefit from preventive medications. Effective prescription drugs include beta blockers (such as propranolol, nadolol and atenolol), certain antidepressants (such as amitriptyline), and certain antiseizure medications (such topiramate and valproate). Difficult cases may benefit from referral to a headache specialist.

Cluster headaches

Cluster headaches are uncommon but very severe headaches, and they occur five times more often in men than women. Although anyone can get cluster headaches, the typical patient is a middle-aged man with a history of smoking.

The problem gets its name because the headaches tend to come in clusters, with one to eight headaches a day during a one- to three-month period every year or two, often at the same time of year. The pain always strikes one side of the head and is very severe. The eye on the painful side is red and watery, the eyelid may droop, and the nose runs or is blocked. The attack starts abruptly and lasts for 30 to 60 minutes. Most sufferers become restless and agitated during the attack; unable to sit still, they pace, jog in place, or beat their head against a wall. Nausea and sensitivity to light and sound may accompany the pain.

Inhaling high flow oxygen soon after the onset of the headache can often stop the attack. Sumatriptan is often effective for cluster headaches, particularly when given by injection. Other triptans may also help. Some patients favor lidocaine nose drops, dihydroergotamine injections, or other treatments. The most effective medication for preventing cluster headache attacks is verapamil, a calcium-channel blocker. Other drugs that may help include divalproex, topiramate, and lithium.

Other types of headaches

Doctors have diagnosed hundreds of conditions associated with headaches. Here are just a few:

Medication headaches. Many drugs number headaches among their side effects. And although it seems paradoxical, many medications used to treat headaches can also cause medication overuse headaches or rebound headaches. Migraine sufferers are particularly vulnerable to a vicious cycle of pain leading to more medication, which triggers more pain. If you have frequent headaches and use medication, OTC or prescription, or both, for more than 10 to 15 days a month, you may have medication overuse headaches. The way to find out is to discontinue or taper your medication — but always consult your doctor first. A corticosteroid such as prednisone may help control pain during the withdrawal period.

Sinus headaches. Acute sinusitis causes pain over the forehead, around the nose and eyes, over the cheeks, or in the upper teeth. Stooping forward increases the pain. Thick nasal discharge, congestion, and fever pinpoint the problem to the sinuses. When the acute infection resolves, the pain disappears. Sinusitis is not a common cause of chronic or recurrent headaches.

Ice cream headaches. Some people develop sharp, sudden headache pain when they eat anything cold. The pain is over in less than a minute, even if you keep eating. If you are bothered by ice cream headaches, try eating slowly and warming the cold food at the front of your mouth before you swallow it.

Headache from high blood pressure. Except in cases of very high blood pressure, hypertension does not cause headaches. In fact, most people with high blood pressure don’t have any symptoms at all, and a study of 51,234 people reported that hypertension was associated with a reduced incidence of headaches. But that’s no reason to neglect your blood pressure. Hypertension leads to strokes, heart attacks, heart failure, and kidney disease, so all men should have their pressure checked, and then take steps to correct abnormalities.

Headache from exercise and sex. Sudden, strenuous exercise can bring on a headache. Gradual warm-ups or treatment with an anti-inflammatory medication before exercise can help. Sexual intercourse may also trigger headaches; some men note only dull pain, but others suffer from severe attacks called orgasmic headaches. Some people can prevent orgasmic headaches by taking an NSAID 30 to 60 minutes before intercourse.

Headache testing

Modern medicine depends on tests to diagnose many problems. For most headaches, though, a good old-fashioned history and physical will do the job. In fact, CT scans, MRIs, and EEGs (brain wave tests) look normal in tension-type headaches, migraines, and cluster headaches. Still, these tests can be vital in patients with warning signs or other worrisome headaches.

Living with constant headaches

For most of us, an occasional headache is nothing more than a temporary speed bump in the course of a busy day. Even so, most men can ease the problem with simple lifestyle measures and nonprescription medications. Relaxation techniques, biofeedback, yoga, and acupuncture may also help. But for some of us, headaches are a big problem. Learn to recognize warning signs that call for prompt medical care. Work with your doctor to develop a program to prevent and treat migraines and other serious headaches. And don’t fall into the trap of overusing medications; for some gents, rebound headaches are the biggest pain of all.

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Headache – causes, in which diseases it occurs, diagnosis and treatment methods

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Encephalitis

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Colds

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Headache – the causes of the appearance, in which diseases it occurs, diagnosis and methods of treatment.
The basis of the headache is irritation of pain receptors located in:

• dura mater and brain vessels;
• periosteum of the skull, vessels of the soft tissues of the head, muscles.

The brain tissue itself does not contain pain receptors.

Types of headaches (cephalgia)

Headaches are divided into primary and secondary. Headache is considered primary if it is the main manifestation of brain disease, such as migraine and tension-type headache.

Secondary headache is a symptom of other disorders, such as head trauma, chronic cerebral ischemia, viral diseases, diseases of the cervical spine, etc.

Let’s take a look at the four most common types of headaches.

Possible causes

Tension headache

Tension headache is the most common form of primary headache. Psycho-emotional stress, depression, anxiety and various phobias, overstrain of the muscles of the shoulder girdle are the main causes of tension headaches.

Migraine headache

Migraines are about three times more common in women than in men, and about 60-70% of all migraines in women are so-called menstrual migraines. However, the causes and mechanism of development of migraine attacks are not fully understood. At any age, both in men and women, migraine attacks can be provoked by emotional and physical overload, malnutrition, drinking alcohol, changing weather conditions, harsh noise, strong odors, etc.

Headache with colds

Headache with colds is caused by hyperthermia and the damaging effect of microbial toxins on brain cells.

Headache in chronic cerebral ischemia

The cause of this pain, which is the most common secondary headache in elderly patients, is the pathology of the cerebral vessels, in which blood circulation is disturbed and the blood supply to the brain tissues deteriorates.

The result is progressive brain dysfunction.

What diseases occur

Tension headache

Tension headache is based on irritation of the structures of the central nervous system (CNS), called the nociceptive system. Myogenic, stress, psychogenic headaches are tension headaches.

Most often, tension headache occurs at a young and working age.

In cases of tension headache, the person experiences bilateral, usually mild, pressing and squeezing, monotonous and dull headaches. Attacks of such pain are accompanied by fatigue, nervousness, impaired appetite and sleep, and decreased performance. The duration of the attack is from 30 minutes to several days.

Migraine headache

Indicates only one disease – migraine, since the attacks of such cephalalgia have a peculiar character. Migraine pain is paroxysmal, throbbing, of moderate or severe intensity. It covers half of the head.

The pain may be aggravated by physical activity, tilting the head, often accompanied by nausea, vomiting.

Bright light, sharp sound, strong smell increase the pain. A migraine attack may be preceded by an aura lasting up to one hour – a collection of visual, auditory, olfactory or other neurological symptoms.
Headache with colds

Occurs with most acute and chronic diseases of the upper and lower respiratory tract caused by bacteria or viruses. In some cases, the intensity of such cephalgia correlates with the severity of fever, the strength of the cough, sore throat and other symptoms. The pain most often spreads throughout the head.

Headache in chronic cerebral ischemia

ic brain injury). In the clinical picture of chronic cerebral ischemia, dizziness, cognitive decline, emotional lability (unstable mood), motor-coordination disorders, and perception disorders (tinnitus, “flies” before the eyes) become indispensable companions of headaches. Headaches are usually mild, distributed throughout the head, and prolonged.

Diagnostics and examinations

Tension headache and migraine headache, headache with colds

Diagnosis is made by a neurologist based on the analysis mnesia and evaluation of patient complaints.

Headache in chronic cerebral ischemia

Radiological examination (doppler ultrasound of cerebral vessels) is the key in chronic cerebral ischemia

Duplex scanning of the brachiocephalic arteries with color Doppler flow mapping

Examination to evaluate blood flow in the vertebral and carotid arteries.

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USG recognizes only relatively large stenoses of cerebral vessels caused by atherosclerotic plaques. CT

CT of the brain and skull

Scanning of the brain, skull and surrounding tissues, which allows diagnosing various pathologies.

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and MRI

CT scan of the brain and skull

Scanning of the brain, skull and surrounding tissues, which allows diagnosing various pathologies.

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Contrast injection

The contrast agent is administered intravenously.

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MRI of the brain

Safe and informative scanning of brain structures for the diagnosis of its pathologies.

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also distinguish between extensive brain lesions due to strokes, but not finely diffuse foci characteristic of chronic cerebral ischemia. In chronic cerebral ischemia, conservative treatment is prescribed.

What should you do when you see one?

Pain is always a sign of a malfunction in the body. You can not tolerate pain or self-medicate. With regular headaches (more than five times a month), it is necessary to consult a doctor as soon as possible.

Tension headache

Stop pain attack with analgesics, non-steroidal anti-inflammatory drugs (NSAIDs), antispasmodics. It is important to remember that many analgesics cannot be taken in the presence of chronic diseases (in particular, with lesions of the gastrointestinal tract, liver and kidneys). Indications and contraindications for the use of certain drugs should be discussed with your doctor.

Migraine headache

Patients with mild attacks are recommended to use NSAIDs and analgesics, with moderate and severe manifestations – specific anti-migraine drugs prescribed by a neurologist after a comprehensive examination.

Cold headache

The main way to deal with such pain is to treat a cold.

Headache in chronic cerebral ischemia

An important aspect of therapy is the fight against atherosclerotic changes in the vessels and cerebral ischemia. It is also necessary to monitor the manifestations of concomitant diseases, for example, arterial hypertension and diabetes mellitus.

Which doctors should I contact?

Tension headache:

• neurologist, psychotherapist;

Migraine headache:

• see a neurologist,
  therapist

Headache with colds:

• k
  therapist, ENT doctor;

Headache with chronic cerebral ischemia:

• k
  neurologist, and
  cardiologist and
  endocrinologist.

Mandatory control of diseases included in the metabolic syndrome group: type 2 diabetes mellitus (DM 2), hypertension, obesity and atherosclerosis.

Treatment

Tension-type headache

Most patients with tension-type headache require therapy prescribed by a psychotherapist and a neurologist. It is also important to pay attention to relaxation and adequate physical activity.

Migraine headache

Treatment includes relief and prevention of attacks.

Headache with colds

Therapy is aimed at treating the underlying disease.

Headache in chronic cerebral ischemia

As a rule, most patients suffer from several diseases, each of which negatively affects the state of cerebral vessels. Thus, the most reliable way to stop the progression of chronic cerebral ischemia is to prevent complications of diseases that are part of the metabolic syndrome group (arterial hypertension, diabetes mellitus, etc. ), which are dangerous in terms of worsening cerebral blood flow.
It is important to give up bad habits (smoking, alcohol abuse, drug use) and follow a diet that includes a large amount of fresh fruits and vegetables and a minimum amount of trans fats.

If chronic ischemia is accompanied by hypertension or diabetes mellitus, daily monitoring of blood pressure and blood glucose levels is advisable. It is necessary to undergo laboratory and instrumental examinations with a certain frequency. You should visit a cardiologist and an endocrinologist at least once a year.

Once every three months, you should take a clinical

Clinical blood test: general analysis, leukoformula, ESR (with microscopy of a blood smear in the presence of pathological changes)

Synonyms: Complete blood count, UAC. Full blood count, FBC, Complete blood count (CBC) with differential white blood cell count (CBC with diff), Hemogram.
Brief description of the study CBC: general a. ..

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and blood chemistry,

Blood chemistry: minimal profile

Up to 1 business day

Available with home visit

3 990 RUB

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in which attention to the level of glucose

Glucose (in the blood) (Glucose)

Research material

Serum or blood plasma. If it is not possible to centrifuge the sample 30 minutes after collection for serum/plasma separation…

Up to 1 business day

Available with house call

335 RUB

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glycated hemoglobin,

Glycated hemoglobin (HbA1С, Glycated Hemoglobin)

Synonyms: Blood test for glycated hemoglobin. Glycohemoglobin; HbA1c; Hemoglobin A1c; A1c; HgbA1c; Hb1c.

Brief characteristics of the analyte Glycated hemo…

Up to 1 business day

Available with home visit

820 RUB

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lipid metabolism indicators

Lipid profile: extended

Up to 1 business day

Available with home visit

3 960 RUB

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and blood coagulation system,

Hemostasiogram (coagulogram), screening

Synonyms: Hemostasiogram, coagulogram.
Coagulation studies (coagulation profile, coag panel, coagulogram).
Profile Composition:
No. 2 Prothrombin (prothrombin time, prothrombin (according to Quick), INR . ..

Up to 1 business day

Available with house call

RUB 1,620

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it is also necessary to undergo an electrocardiographic study (ECG),

ECG in 5 minutes

Examination of the functional capabilities of the heart – quickly, painlessly and informatively.

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Echocardiography.

Echocardiography

Examination to assess functional and organic changes in the heart, its contractility, as well as the state of the valvular apparatus.

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If abnormalities occur, you may need to take antidiabetic drugs, statins, or anticoagulants. Ultrasound should be performed at least twice a year

Duplex scanning of the brachiocephalic arteries with color Doppler flow mapping

Examination to evaluate blood flow in the vertebral and carotid arteries.

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to control the progression of atherosclerosis of cerebral and aortic vessels.

Sources:

1. Clinical guidelines “Migraine”. Developed by: All-Russian Society of Neurologists, Russian Society for the Study of Headache. – 2021.
2. Clinical guidelines “Acute respiratory viral infections (ARVI) in adults.” Developed by: National Scientific Society of Infectionists, Russian Scientific Medical Society of Therapists. – 2021.

IMPORTANT!

The information in this section should not be used for self-diagnosis or self-treatment. In case of pain or other exacerbation of the disease, only the attending physician should prescribe diagnostic tests. For diagnosis and proper treatment, you should contact your doctor.
For a correct assessment of the results of your analyzes in dynamics, it is preferable to do studies in the same laboratory, since different laboratories can use different research methods and units of measurement to perform the same analyzes.

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HEADACHE – Hadassah Medical Moscow

Traditional migraine therapy consists of behavioral therapy, relief of an already developed attack and preventive treatment aimed at preventing attacks. Behavioral therapy, a necessary step in effective patient management, is carried out during a conversation with the patient and includes: explaining the benign nature of migraine, dissuading the presence of an organic disease, discussing the role of attack triggers and the need to avoid them, risk factors for migraine chronicity (taking a large number of painkillers, stress , psycho-emotional states), as well as the rationale for treatment tactics (mechanisms of action of prescribed drugs).

Treatment of a migraine attack is prescribed depending on its intensity and the degree of maladaptation of the patient. With infrequent attacks of mild or moderate intensity, simple or combined analgesics are indicated; with severe nausea and vomiting – antiemetics. With a high intensity of pain and significant maladaptation, triptans are prescribed.

New drug groups have been approved worldwide for the treatment of migraine attacks. This, in turn, enables doctors to treat their patients more effectively, and for patients to reduce the number of days with a headache, improve quality of life, sleep, mood and performance.

Lasmiditan is a selective serotonin 1F receptor agonist that does not have vasoconstrictive activity. The role of lasmiditan in clinical practice has not yet been determined, but it is probably best suited for patients with relative contraindications to triptans due to cardiovascular risk factors.

In October 2019, the US Food and Drug Administration (FDA) approved lasmiditan oral tablets for the treatment of acute migraine in adults. The drug is currently not registered in the Russian Federation.

CGRP antagonists (Rimegepant and Ubrogepant) Monoclonal antibodies directed against the CGRP receptor or ligand. These are oral options available for the acute treatment of migraine in patients with insufficient response or contraindications (eg coronary artery disease) to triptan treatment.

Ubrogepant received US Food and Drug Administration (FDA) approval for the treatment of acute migraine in adults in December 2019year, and rimegepant received a similar FDA approval in February 2020. This group of drugs is not registered in the territory of the Russian Federation.

Preventive therapy is aimed at reducing the frequency, duration, intensity of attacks, the number of doses of painkillers and improving the quality of life of patients.

The main indications for course treatment: the frequency of days with GB > 4 per month, the lack of effectiveness of drugs for the relief of migraine attacks, the presence of risk factors for migraine chronicity (abuses, depression), prolonged aura (> 60 min). The duration of the course of treatment is from 3 to 12 months (an average of 4-6 months for episodic, 8-12 months for chronic migraine), then an attempt is made to gradually withdraw the drug (s) or reduce their dosage.

CGRP antagonists is a human monoclonal antibody that binds to and inhibits the calcitonin gene-related CGRP receptor (CGRP) and is a therapeutic target in migraine due to its putative role in mediating the transmission of trigeminovascular pain and the vasodilator component of neurogenic inflammation

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Large molecules in the form of monoclonal antibodies directed against the CGRP receptor or ligand are injected to prevent migraine.