Headaches are a pain or discomfort that can be generalized or local affecting any part of the cephalum (head). There are many causes of head aches, some originating from the head region itself, others are referred from the neck and upper back, as well as ophthalmologic origins.

Most causes of headache’s are benign and have no underlying significant pathology, however, it is important to have a physician or pain specialist rule out more severe causes before beginning headache treatment for the benign causes.

Headaches themselves are one of the most common complaints from people visiting a physician.

A headache specialist will then classify the head ache as “Primary” or “Secondary.” Primary head aches are not caused by an underlying pathology or disease.

Meaning, they are benign head aches which can further be subdivided as Cluster, Tension, and Migraine headaches. Secondary headaches are associated with a pre-existing pathology causing the pain, which may be benign or malignant of origin.

headache cureThere are many causes of secondary headaches that should be excluded by a headache specialist before assuming a headache is of primary origin.
Some of the more severe causes that require immediate treatment are intracranial hemorrhages/ hematomas, meningeal infections (viral, bacterial, fungal), strokes, and malignant hypertension.

Other pathologies that are more subacute, or have an insidious onset may be malignant tumors (primary or malignant) or ophthalmologic (glaucoma, cataract).

There are other diseases associated with headache and these all should be evaluated by your physician before treating your headache.

Your physician may wish to order radiological studies (MRI, CT scan), neurological exam, blood work, or an eye/vision assessment to help rule out some of the causes of secondary headache. Primary headaches are much more common and can be broken down into three categories; Cluster, Tension, and Migraine headaches.

 

Cluster Headaches

In Cluster headache, men are more commonly affected than women with a peak age of onset around 25 years.
Patients will present with a severe, unilateral, pulsatile, periorbital pain that typically lasts anywhere from 20 minutes to 3 hours.

Patients describe the pain associated with Cluster headache to be far more severe than is experienced in Tension or Migraine headaches.

Risk factors for Cluster headaches are vasodilating medications as well as recent alcohol or illicit drug use.

A specific trait to Cluster headache’s are that they occur in “clusters”, hence the name, meaning they affect the same location of the head, around the same time of day, during the same time of year.

Patients may also experience tearing from the eye on the same side of the head as the pain as well as nasal discharge or stuffiness, or neurological complications (Horner’s syndrome, ptosis).

In contrast with the other two types of primary HA, emotion and food are NOT triggers in Cluster headaches.

Tension Headaches

Tensions headaches are considered the most common headache diagnosed in adults.

The pain is described as a restrictive, band like pain that is being wrapped around the patients head.

Patients describe it as an insidious (slow) onset and can be exacerbated by bright lights, noise, and especially stress.

A patient experiencing Tension headaches may also have an associated Depression, sleep disturbance, or poor concentration.

These typically occur towards the end of the day and are located in the upper neck and occipital (back of head) region.

Unlike Cluster and Migraines, Tension headaches are not associated with any neurological disturbances and are usually a diagnosis of exclusion.

Migraine Headaches

Migraines are more common in women and affect a significant portion of the population. Migraine headache’s can be experienced in children, adolescents, adults, and geriatric patients and varies significantly with each person.

They can be seen in anyone! The pain associated with Migraines is described as either unilateral (one-sided) or bilateral (both sides), intense and throbbing that typically lasts over an hour but less than 24 hours.

Migraines are further classified as “Classical” and “Common.” In Classical Migraines the pain is unilateral and is preceded by an aura .

A Common Migraine is often bilateral and has no associated aura or neurological manifestation. One of the known phenomena of a Migraine headache is that many people, although not all, have an associated aura that may occur before, during, or after the onset of the migraine.

Some patients describe the aura as scintillating flashes of light, a particular smell, spots of vision loss, as well as numbness of one or both sides of the face, unsteadiness, weakness, or an altered level of consciousness.

Nausea and vomiting are also common among patients who suffer from Migraine headaches. There are many occurrences that can “trigger” a migraine attack.

Some of the most commonly associated triggers are loud noise, bright lights, certain foods (chocolate, peanut butter, avocado, banana, citrus, dairy products, and fermented/ pickled foods, MSG), certain medications (birth control pills, migraine medications), menstrual cycle fluctuations, exertion activities, as well an underlying emotional and/ or psychiatric diseases, such as Depression.