Headache

The umpteen different types of headaches

What is headache pain?

Headache is one of the most common symptoms that may be experienced at multiple points in a person’s lifetime. According to research, more than half of the world’s adult population is expected to have suffered a headache in the last year. It is annoying and bothersome. It can disturb your routine and it may be related to diseases. Headache disorders are described as recurrent headaches associated with social and personal burdens, and impaired quality of life.

When headache occurs?

Headache occurs when tissues, skull bones, and structures surrounding the brain are stretched, irritated, or inflamed. The brain itself has no pain nerves.

Where is it?

It can involve one or more parts of the head; the temples on one side or both, the top of the head or the crown, the back or the occiput, or even the face. It can shift from one site to others, it can radiate from one part to another, and it can extend to involve the whole head.

How is it?

Any pain in the body is describable by a set of characters:

  1. Mild, moderate, or severe intensity
  2. sharp, throbbing, or dull nature
  3. continuous or intermittent
  4. gradual or sudden in onset
  5. worsening or consistent
  6. lasting for minutes, hours, or days
  7. began spontaneously or secondary to a triggering event.

Why headache occurs?

According to the International Headache Society, headaches are dividable into three categories depending on the cause; primary or secondary or cranial neuralgia. A patient with a headache may have one or more types of headaches at any moment.

  • Primary headaches:

These types of headaches arise from the pain-sensitive structures within the head and have no definable cause behind it. It can result from over-activity, chemical imbalance, genetic disposition, or may be triggered by specific factors, such as intake of caffeine or alcohol, changes in sleep, skipped a meal, flashy lights or too much noise. These headaches can have patterns with distinctive features like throbbing, preceding aura, or association with nausea.

Primary headaches reduce the quality of life and can be debilitating. These occur as attacks, have variable resolving time, and can have very debilitatingeffects. Theseare mostly non-life-threatening in nature but sometimes the associated symptoms may resemble brain diseases and stroke.

Primary headaches include migraine, cluster headaches, tension-type headaches and others.

  • Secondary headache:

As the name suggests, these headaches occur in response to underlying diseases like infections or structural problems. The causes of such headaches can be anything from sinus infections, dental inflammations, substance abuse, hangover, medication overuse, and dehydration, brain bleeds, brain infections and trauma.

  • Cranial neuralgia and facial pains:

This category includes the headaches caused by pain or irritation in the 12 nerves of the head and neck. These nerves directly connect the head, neck and face to the brain. This type includes trigeminal neuralgia and post-herpetic neuralgia.

A list of some types of headaches classified by the International headache society.

  1. Migraine-  This is the second most common type of headache, more common in females. Migraine can occur with or without preceding symptoms of vision and hearing called aura. 1 in every 20 persons suffers from migraine everyday and it is quite debilitating. Specific clinical protocols have been developed to help diagnose this condition and prevent migraine episodes.
  2. Tension-type headache – This is the most common type of headache, seen in approximately 30-70% of the world’s population. This can be episodic or chronic, and resemble migraine without aura. These are usually accompanied by temporal tenderness.
  3. Cluster Headache- This is considered a type of trigeminal cephalalgia and it also has protocols built to help diagnose and prevent these headaches. These are very painful, last a few minutes, and involve the face.
  4. Cough headache- Headache triggered by coughing or straining.
  5. Exercise headache- headache induced by exercise in the absence of any head and neck disorder.
  6. Headache associated with sexual activity- It can occur before or after orgasm.
  7. Thunderclap headache- High intensity, sudden onset headache in the absence of any intracranial disease. It resembles ruptured aneurysm but is benign.
  8. Ice cream/cold stimulus headache- Headache following exposure to low temperature.
  9. External compression/traction headaches- These occur secondary sustained traction on skull but without damage, such as from tight ponytails
  10.  Stabbing Headaches- are short-lived stabbing, ice-pick feeling pains in the head.
  11.  Nummular headache- headache of variable nature but described as small circular spot of pain.
  12.  Hypnic headache-  headache that repeatedly occurs in sleep, waking the patient up and lasting for a few hours.
  13.  New daily persistent headache- persistent headache starting with the day and lacking characters of other significant types, like migraine.
  14.  Headache secondary to
    1. trauma or injury
    1. cranial/cervical vascular disorder
    1. non-vascular intracranial disorder
    1. substance abuse and withdrawal
    1. infections
    1. blood disorders
    1. disorders of face, eyes, ears, nose, teeth, mouth, sinuses, cranium, or neck
    1. psychiatric disorder
  15. Trigeminal neuralgia-  Pain limited to one side of the face, lasting few seconds to minutes, and shock-like in nature.
  16.  Headache secondary to involvement nerve of the tongue
  17.  Headache associated with nerves after infection like post-herpetic neuralgia
  18.  Unspecified, unclassified type of headache.

When is it important:

Headache is common but it may be a sign of an underlying disease. Some important conditions to keep in mind that should prompt to see a doctor in emergency include:

  • Worst, severe headache that came on suddenly
  • Confusion, change in behaviour
  • Fainting
  • High grade fever
  • Numbness or weakness of one side of body
  • Stiff neck
  • Nauseas or vomiting
  • Trouble seeing, speaking, hearing, walking, breathing.

Also see a doctor when the headache is:

  • New onset
  • Occur more frequently than usual
  • More severe than usual
  • Worsened or unimproved by medicines
  • Disturbs your routine

Conclusion

Headaches are a source of nuisance but can be a symptom of an underlying issue. It is always better to get it checked especially if there is something unusual about it.

See Also
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