What Are the Types of Headaches?
Also known as chronic daily headaches or chronic non-progressive headaches, tension headaches are the most common type of headaches among adults and adolescents. These muscle contraction headaches cause mild to moderate pain and come and go over a prolonged period of time.
The exact causes of migraines are unknown, although they are related to blood vessel contractions and other changes in the brain as well as inherited abnormalities in certain areas of the brain. Migraine pain is moderate to severe, often described as pounding, throbbing pain. They can last from four hours to three days and usually occur one to four times per month. Migraines are associated with symptoms such as sensitivity to light, noise, or odors; nausea or vomiting; loss of appetite; and stomach upset or abdominal pain.
Mixed headache syndrome:
The least common — although the most severe — type of primary headache, the pain of a cluster headache is intense and may be described as having a burning or piercing quality that is throbbing or constant. The pain is so severe that most cluster headache sufferers cannot sit still and will often pace during an attack. The pain is located behind one eye or in the eye region, without changing sides. The term “cluster headache” refers to headaches that have a characteristic grouping of attacks. Cluster headaches occur one to three times per day during a cluster period, which may last two weeks to three months. The headaches may disappear completely (go into “remission”) for months or years, only to recur.
Sinus headaches are associated with a deep and constant pain in the cheekbones, forehead, or bridge of the nose. The pain usually intensifies with sudden head movement or straining and usually occurs with other sinus symptoms, such as nasal discharge, feeling of fullness in the ears, fever, and facial swelling.
How is Headaches Diagnosed?
In order to receive proper treatment, a correct diagnosis of your headaches or migraines must be made. To properly diagnose the cause(s) of the headaches, your doctor will first take a headache history.
The most important part of your doctor’s evaluation of your headaches is what’s called the headache history. It is important to describe your headache symptoms and characteristics as completely as possible. Your headaches can be better diagnosed if you tell your doctor:
- How old you were when the headaches started
- How long you have been experiencing them
- If you experience a single type of headache or multiple types of headaches
- How often the headaches occur
- What causes the headaches, if known (for example, do certain situations, foods, or medications trigger the headaches?)
- Who else in your family has headaches
- What symptoms, if any, occur between headaches
- If your school or work performance has been affected by the headaches
It is also important to tell your doctor how you feel when you get a headache and what happens when you get a headache, such as:
- Where the pain is located
- What it feels like
- How severe the headache pain is, using a scale from one (mild) to 10 (severe)
- How long the headache lasts
- If the headaches appear suddenly without warning or with accompanying symptoms
- What time of day the headache usually occurs
- If there is an aura (changes in vision, blind spots, or bright lights) before the headache
- What other symptoms or warning signs occur with a headache (such as weakness, nausea, sensitivity to light or noise, appetite changes, changes in attitude or behavior)
- How frequently you get headaches
You should also tell your doctor if you’ve been treated in the past for headaches and what medications (both prescribed and over-the-counter) you have taken in the past and what medications are currently being taken. Don’t hesitate to list them, bring the bottles, or ask your pharmacist for a printout.
Studies performed by other doctors who may have evaluated your headaches in the past, including X-rays and other imaging tests are also very important — you should bring these to your appointment as well. This may save time and repetition of tests.
Physical and Neurological Exams to Diagnose Headaches
After completing the headache history portion of the evaluation, the doctor will perform a complete physical and neurological exam
Neurological tests focus on ruling out diseases of the brain or nerves that may also cause headaches and migraines, such as epilepsy or multiple sclerosis. Some of the tests may also look for a physical or structural abnormality in the brain that may cause your headache, such as:
- Abscess (an infection of the brain)
- Hemorrhage (bleeding within the brain)
- Bacterial or viral meningitis (an infection or inflammation of the membrane that covers the brain and spinal cord)
- Pseudotumor cerebri (increased intracranial pressure)
- Hydrocephalus (abnormal build-up of fluid in the brain)
- Infection of the brain such as meningitis or Lyme disease
- Encephalitis (inflammation and swelling of the brain)
- Blood clots
- Head trauma
- Sinus blockage or disease
- Blood vessel abnormalities
- Aneurysm (a “bubble” in the wall of a blood vessel that can leak or rupture)
An EEG, or electroencephalogram, is a test in which the electrical signals of the brain are recorded. The electrical activity is detected by electrodes, or sensors, placed on a person’s scalp and is transmitted to a polygraph that records the activity.