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 Migraine & Headaches 

 Reference 

Headache Basics
ARTICLES ONTYPES OF HEADACHES
  Headache Basics
 Sinus Headaches
 Tension Headaches
 Migraine Headaches
 Cluster Headaches
 Thunderclap Headaches
 Ice Pick Headaches
 Rebound Headaches
 New Daily Persistent Headaches
 Spinal Headaches
 Cervicogenic Headaches
 Chronic Daily Headaches
 Low & High Pressure Headaches
 Altitude Headache
 Occipital Neuralgia
 Hemicrania Continua
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.

Common Types of Headaches

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, she 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 starts 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.

Less Common Headaches

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
Hemicrainia 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.

Rare Headaches
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.

What Causes Headaches?

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. A popular theory is that triggers cause
unusual brain activity, which leads to changes in the blood vessels there. Some forms of
migraines are linked to genetic problems in certain parts of the brain.
Too much physical activity can also trigger a migraine in adults.

Getting a Diagnosis
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.

How Are Headaches Treated?

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.

What Happens After I Start Treatment?

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.
WebMD Medical Reference Reviewed by Jennifer Robinson, MD on September 7, 2018

Sources

© 2018 WebMD, LLC. All rights reserved.

NEXT IN TYPES OF HEADACHES SERIES:

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