Headache: Types, Causes, Symptoms, Diagnosis & Treatment

 

Most people will experience suffering from headaches frequently throughout their lives. Pain in the head or face is the main symptom of a headache. Though there are several types of headaches, tension headaches are the most common. Although the majority of headaches are not dangerous, some types may indicate a significant underlying condition.

What is a headache?

A headache is a type of pain in the head or face that can often be described as a dull, acute, throbbing pressure. The kind, intensity, location, and frequency of a headache might vary substantially.
Most people will suffer from headaches frequently throughout their lives. They are the most prevalent type of pain and are frequently given as an excuse for missed work or school days and doctor visits.

Although the majority of headaches are not dangerous, some types may indicate a more serious illness.

Typical headache types:

 Tension headaches: 

Adults and teenagers most frequently have tension headaches. They come and go throughout time, causing from mild to moderate pain. Usually, they don't exhibit any further symptoms.

Headaches from migraine:

A common description of a migraine headache is pounding, hammering pain. They typically occur one to four times per month and can last anywhere from four hours to three days. In addition to the pain, others have nausea or vomiting, lack of appetite, sensitivity to light, noise, or smells, and upset stomach or gut ache. A youngster suffering from a migraine may experience symptoms such as paleness, dizziness, blurred vision, fever, and upset stomach. Vomiting is one of the few digestive symptoms associated with children's migraines, and it happens about once a month.

Headaches in clusters:

The most severe headaches are these. One eye may be severely burned or pierced behind or around. It may be continuous or throbbing. Most patients with cluster headaches find it impossible to sit still during the attack and frequently pace because of the terrible sensation of pain. The eyelid droops, the eye reddens, the pupil gets smaller, or the eye starts to tear on the side where the pain is. That side's nostril runs or constricts.

Because they frequently occur in clusters, they are known as cluster headaches. They may appear one to three times a day for the duration of a cluster period, which can extend from two to three months. There is a 15- to 3-hour duration for each headache attack. You may be roused from sleep by them. For months or years, the headaches may entirely stop (your doctor will refer to this as a remission) before returning at a later time. Compared to women, men are three to four times more likely to get them.

 

 Chronic headaches daily:

This type of headache is yours. For more than three months, at least fifteen days or more a month. A few are short. Others go more than four hours. Usually, it's one of the following four basic headache types:

• Chronic migraine
• Chronic stress headache
• New, persistent headache daily
• Hemicrania persistente

Headaches in the sinus:

A severe, constant pain in your forehead, nose bridge, or cheeks occurs when you have a sinus headache. They develop from inflammation of the sinuses, which are cavities in your head. Typically, the discomfort comes with other sinus symptoms such as fever, swollen face, runny nose, and fullness in the ears. Unlike the clear discharge from cluster or migraine headaches, the gunk coming out of your nose will be yellow or green if you have a real sinus headache, which is caused by a sinus infection.

Posttraumatic headaches:       

Head injuries typically cause posttraumatic stress headaches two to three days later. You'll feel:

• A constant, dull ache that may get worse
• Vertigo
• Lightheaded
• Trouble concentrating
• Memory issues
• Fast-fading
• Intolerance
• A few months may pass between headaches. But give your doctor a call if, after a couple of weeks, it doesn't improve.

Less frequency of headaches:

Exercise headaches:

The muscles in your head, neck, and scalp require more blood when you're moving around. The blood vessels swell to supply them. Your head will hurt in a pulsing manner for five to forty-eight hours on both sides as a result. It frequently happens during or right after an activity, such as exercise.

Hemicrania keep going:

The same side of your face and head is nearly always affected by hemicrania continua, a persistent, chronic headache. Additional signs and symptoms consist of:

• Pain with different levels of severity
• Eyes that are red or teary
• Stuffy or runny nose
• Drooping eyelid
• Iris contraction in response to indomethacin pain treatment
• Increased pain when moving around

Some also see the following signs of migraines:

• vomiting and nausea
•  Sensitivity to sound and light

Two categories exist:

Chronic: You get headaches every day.
Remitting: You get six months of headaches. They go for a few weeks or months, then come back.

Headaches in the spinal:

Intense headaches known as spinal headaches are caused by a spinal tap-related leak of spinal fluid from the membrane covering your spinal cord. The majority of spinal headaches are treatable at home, but if left untreated for an extended period, they can result in potentially fatal consequences such as seizures and subdural hematoma.

Headaches that strike suddenly and with great agony, much like a thunderclap, are known as thunderclap headaches. This type of headache lasts for at least five minutes and reaches its peak pain in just one minute. Even though thunderclap headaches are occasionally benign, it's crucial to get medical help right once. They may indicate

• Head trauma.
• Bleeding in the brain.
• Syndrome of reversible cerebral vasoconstriction.
• An abrupt and extreme increase in blood pressure.

What do headaches cause?

The combination of signals from your brain, blood vessels, and surrounding nerves causes the pain you experience when you have a headache. Certain nerves in your brain's muscles and blood vessels activate and send pain signals to your brain. However, it's unclear how these signals are first activated.

Typical headache reasons include:

Illness.

This can involve fevers, colds, and infections. A throat infection, an ear infection, or sinusitis (inflammation of the sinuses) can also cause headaches. Headaches can occasionally be caused by a blow to the head or, less frequently, be an indication of a more serious medical problem.

Tension.

 Meal skipping, irregular sleep habits, emotional tension, and sadness, as well as overmedication. Poor posture can also lead to tension in the neck or back.

Your environment, includes allergens, certain food, strong odors from household chemicals or fragrances, and secondhand tobacco smoke. Other potential factors include stress, pollution, noise, illumination, and variations in the weather.

Genetics.

Migraine headaches especially are known to run in families. Ninety percent of children and teenagers with migraines have other family members who also suffer from them. There is a 70% likelihood that a child will experience migraines if both parents have a history of them. The chance decreases to 25%–50% if only one parent has a history of severe headaches.

Experts are unsure about the precise cause of migraines. According to one concept, migraines are the result of a series of changes brought on by an issue with the electric charge passing through nerve cells.
Adults who engage in excessive physical exercise may also experience migraines.

Which headache symptoms call for emergency medical attention?

Get immediate medical attention if any of these headache symptoms apply to you or your child:

• A sudden, intense headache that is novel.
• Fever, rash, stiff neck, shortness of breath, and headache together.
• Headaches brought on by accidents or head injuries.
• Getting a new headache kind beyond the age of 55.

If your headache is accompanied by any neurological symptoms, such as the following, get medical attention very immediately.

• Weakness.
• Dizziness.
• Sudden loss of balance or falling.
• Any tingling or numbness.
• Immobility.
• Speech difficulties.
• Confusion in the mind.
• Seizures.
• A shift in personality or inappropriate behavior.
• Vision changes such as double vision, blind patches, or blurry vision.

How are migraines assessed and diagnosed?

Talk with your healthcare physician if you get severe or frequent headaches.

It's critical to accurately diagnose headaches so that the physician can prescribe the right kind of therapy to make you feel better. In addition to performing a physical examination and talking with you about your headache symptoms, your physician will also go over your medical history. This discussion is a component of a headache evaluation.

Your healthcare professional will inquire about your headache history during the evaluation, covering the following topics:

• The feeling of the headaches.
• The frequency of the headaches.
• How long does each headache last?
• How much pain do you feel from the headaches?
• What beverages, food, or activities trigger your headaches?
• The amount of caffeine you drink daily.
• How stressed out are you?
• The nature of your habits of sleep.

Your provider may conduct physical and neurological examinations following the completion of the medical history portion of the evaluation. They'll search for indications of a disease or other ailment that could be the source of the headache, such as:

• High temperature.
• Infection.
• High blood pressure.
• Tingling, numbness, or weakening of the muscles.
• Excessive fatigue.
• Unconsciousness.
• Having trouble with balance and falling frequently.
• Issues with eyesight (double vision, blind spots, hazy vision).
• Perplexity or personality shifts.
• Seizures.
• Dizziness.
• Vomiting as well as nausea.

What examinations are planned for diagnosing headaches?

Scanners and other imaging tests help rule out other conditions, but they do not help in diagnose migraines, cluster headaches, or tension headaches.

However, there are a few imaging tests that your doctor might perform if they believe that another medical problem is the source of your headaches.

If you're not sure whether your headaches are related to a problem with your central nervous system, an MRI or CT scan can help. These two tests yield cross-sectional brain scans that can reveal any abnormalities or problems.

How do you treat a headache?

The sort of headache will determine how it is treated.

Determining your triggers is one of the most crucial aspects of managing primary headaches. You can experience fewer headaches by finding out what those are, usually by maintaining a headache log.

Knowing what your triggers are will help your healthcare professional customize a plan just for you. For instance, tension or worry can give you a headache. You can better control this trigger with the use of counseling and techniques for reducing stress. You can steer clear of headaches brought on by stress by reducing your stress level.

Medication is not always necessary for headaches. There are numerous therapy options. Treatment choices vary depending on the type, frequency, and cause of your headaches. They include:

• Management of stress.
• Biofeedback.
• Medication.
• Treating the underlying medical conditions or causes.

Management of stress:

You can learn ways to cope through stress management. Stress management is made possible by techniques for relaxation. To relieve tension, you employ deep breathing, muscular relaxation, visualization techniques, and music.

Biofeedback:

You can learn to recognize the indications of tension in your body through biofeedback. You learn how your body responds to stressful situations and how to defuse them. The body of the user is customized with sensors during biofeedback. They maintain a record of your uncontrollably occurring physical reactions to headaches, such as spikes in:

• Respiration rate.
• Rhythm.
• Heart rate.
• The degree of warmth.
• Tense muscles.
• Brain activity.

 Medications:

Over-the-counter pain medications usually work effectively for occasional tension headaches. However, be aware that overusing these medications may result in chronic daily headaches (also known as medication overuse headaches).

Your clinician may suggest prescription headache drugs if you experience severe or frequent headaches. A migraine attack can be stopped using triptans and other medications. When a headache appears, you take them right away.

Sometimes, medications used to treat depression, seizures, and high blood pressure can also stop migraines. To reduce the frequency of headaches, your doctor may recommend you try one of these medications.

Treating the underlying medical conditions or causes:

Treating the underlying medical issue that is generating the headache is part of the treatment for secondary headaches.
For instance, for example, to take care of the underlying cause of a secondary cough headache, surgery is frequently required.

How may a headache be relieved?

Over-the-counter painkillers can be used at home to alleviate the occasional light headache. Other headache remedies that can be done at home include:

• Applying cold or heat packs on your head.
• Exercising your limbs.
• Giving your neck, head, or back a massage.
• Resting in a quiet, dark place.
• Taking a walk.

Prevention:

Determining the cause of a headache is key to preventing it. Everybody has extremely different triggers; what gives you a headache cannot bother others. You can reduce or avoid your triggers once you've determined them.

For example, you might discover that strong scents irritate you. The amount of headaches you get can be significantly reduced by avoiding scented items like perfumes. The same holds for other typical triggers such as uncomfortable foods, lack of sleep, and poor posture.

However, a lot of people are either unable to recognize or avoid triggers. In such instances, a more personalized multidisciplinary approach with a headache specialist is often necessary.

References:

• National Headache Foundation. Are Headaches Hereditary? (https://headaches.org/2011/01/20/readers-mail-are-headaches-hereditary/) Accessed 7/7/2022.

• World Health Organization. Headache Disorders (https://www.who.int/en/news-room/fact-sheets/detail/headache-disorders). Accessed 8/29/2022.

• American Migraine Foundation. Sinus Headaches (https://americanmigrainefoundation.org/resource-library/sinus-headaches/). Accessed 8/29/2022.

• American Migraine Foundation: “Primary Exercise Headache,” “Primary Stabbing Headache (Ice Pick Headache).”

• MedlinePlus. Headache (https://medlineplus.gov/ency/article/003024.htm). Accessed 8/29/2022.

• National Institute of Neurological Disorders & Stroke. Headache Information Page (https://www.ninds.nih.gov/Disorders/All-Disorders/Headache-Information-Page). Accessed 8/29/2022.