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Headaches

Also called: Primary Headaches, Secondary Headaches, Cephalalgia

- Summary
- About headaches
- Types and differences
- Risk factors and causes
- Signs and symptoms
- Diagnosis methods
- Treatment and prevention
- Questions for your doctor

Reviewed By:
Vikas Garg, M.D., MSA

Types and differences of headache

There are many types of headache. The International Headache Society has composed a comprehensive list of more than 150 types of headache. According to the society’s classification of headache disorders, headaches may be categorized as primary, secondary or cranial neuralgias.

Primary headaches are often a tension headache, migraine or cluster headache. Secondary headaches can be caused by numerous underlying conditions or injuries, such as head or neck trauma or disorders, blood vessel disorders within the head and neck, infection, tumor, facial pain, certain eye conditions, and many substances including medications.

Cranial neuralgias (nerve pain in the head) include central and primary facial pain and other headaches.

According to the American Council for Headache Education, more than 90 percent of headaches are primary headaches. Headaches classified as primary are not due to an underlying condition and are typically not life-threatening.   

The most common types of primary headache include:

  • Tension headache. Also known as a tension-type headache, this is the most common form of headache. It typically produces a dull and pressure-like pain in the head, neck and scalp. Tension headaches are most common in patients between the ages of 30 and 39. The condition is also more common in women. This type of headache typically develops early in the day, often after a person wakes up.

  • Migraine. This is the second most common form of headache. It typically appears as a throbbing ache near one side of the forehead. Migraines may be accompanied by a number of other symptoms, including nausea, vomiting and temporary visual changes (aura). The condition occurs most often in women and patients between the ages of 15 and 55. Migraines are also more likely to occur in people with migraine sufferers in their immediate family (e.g., parent, sibling).

  • Cluster headache. Typically appears as a sharp, penetrating or burning pain, usually involving only one side of the head. The pain is most often felt in or around the eye or in the temple. Many times the head pain is accompanied by drooping of the eyelid and nasal congestion on the same side as the pain. This type of headache usually appears as a series of headaches (cluster), separated by pain-free periods of remission lasting for months or years. It is more common in men than women. 

Other types of primary headache include:

  • Primary cough headache. This type of headache can be triggered by coughing, as well as sneezing, laughing or bending over. It typically appears as a sharp or stabbing pain located on both sides of the head and at the back of the skull. It usually develops suddenly and lasts anywhere from a few seconds to several minutes. Primary cough headaches occur more often in men.

  • Primary exertional headache. This type of headache is triggered by prolonged physical exercise (e.g., weightlifting, running, dancing). They typically produce a throbbing pain on both sides of the head. The pain, which slowly intensifies, can last anywhere from five minutes to 48 hours.

  • Primary headache associated with sexual activity. This type of headache can occur during intercourse (preorgasmic headache) or during orgasm (orgasmic headache). Preorgasmic headache typically appears as a dull ache in the head and neck that slowly intensifies with sexual excitement. Orgasmic headaches usually present as a severe pain during orgasm. The head pain associated with sexual intercourse may last anywhere from a minute to three hours. Sexual pain is also known as dyspareunia.

  • Primary thunderclap headache. This form of headache produces severe pain that typically reaches peak intensity in less than a minute. The pain can last anywhere from an hour to several days.

Unlike primary headaches, secondary headaches are symptoms of other diseases or conditions. Types of secondary headache include:

  • Sinus headache. Headache may accompany sinusitis, a common condition involving inflammation of the sinuses. Indicators include orofacial pain over the cheeks and forehead and sometimes eye pain. It can be confused with a migraine. People prone to colds and allergies face increased risk of sinus headache.

  • Delayed alcohol-induced headache. Also known as hangover headaches, delayed alcohol-induced headaches typically appear as a pulsating pain in the front and on both sides of the head. This type of pain, which may occur after a period of excessive drinking, can intensify with movement.

  • Monosodium glutamate-induced headache. Monosodium glutamate (MSG) is a food additive often found in Chinese foods, meat tenderizers, processed meats, canned soups and other processed foods. Foods containing the ingredient can trigger a dull and constant pain at the front or on both sides of the head. It typically occurs within 30 minutes of consumption and resolves within 72 hours.

  • Medication-overuse headache. Also known as an analgesic rebound headache, this type of headache results from overuse of pain medication. Taking prescription or nonprescription medication daily or almost daily can cause a headache to rebound as the medication begins to wear off.

  • External compression headache. Continuous pressure on the forehead or scalp can trigger a headache. Placing certain objects on the head, such as a tight hat, goggles or a headband, can cause constant head pain. This pain is typically worse in the area where the object is pressing on the head. 

  • Headache attributed to ingestion or inhalation of a cold stimulus. Commonly referred to as an ice cream headache, this type of headache results from cold material moving along the palate and across the throat. It may be triggered by quickly consuming ice cream, a cold drink or inhaling cold air. The pain, which typically appears as a sharp, stabbing pain in the forehead, usually peaks about 30 seconds after it develops and resolves within two minutes.

  • Headache attributed to low cerebrospinal fluid pressure. Also known as a post-lumbar puncture headache, this type of headache may occur after a spinal tap (lumbar puncture). A spinal tap is a procedure in which a needle is used to remove a sample of cerebrospinal fluid from between vertebrae in Anatomy of the spine includes the cervical spine, thoracic spine, lumbar spine and sacral region.the lower spine. It typically appears within one week after the procedure and usually disappears within two to three weeks or after treatment for a spinal fluid leak. This type of headache is usually worsened by standing, straining (e.g., cough) or sitting up and relieved by lying down.

  • Carbon monoxide-induced headache. Carbon monoxide is a colorless, odorless gas that reduces the body’s ability to carry oxygen to the brain. Carbon monoxide poisoning can trigger a dull and constant pain in the head. The pain typically disappears within 72 hours after a person stops breathing the gas. Sources of carbon monoxide include exhaust from combustion engine (e.g., automobile engines), portable propane heaters, barbecue charcoal, and portable or non-vented natural gas appliances.

The many other causes of head pain include cranial neuralgias, occipital Lupus is a chronic autoimmune disease that can cause joint pain and inflammation (arthritis).neuralgia, fatigue, chronic fatigue syndrome, fibromyalgia, myofascial pain syndrome, encephalitis, meningitis, Lyme disease, temporal arteritis, TMJ disorder, whiplash and lupus.

Headache may also be due to referred pain from sources of dental pain, ear pain, eye pain, neck pain or shoulder pain.

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Review Date: 01-19-2007
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