Headache
Medical Author: Benjamin C. Wedro, MD, FAAEM
Medical Editor: Jay W. Marks, MD
Questions to Ask Your Doctor About Headaches
Medical Author: Dennis Lee, MD
Medical Editor: Melissa Conrad Stöppler, MD
 Headache is defined as pain in the head that is located above the eyes or the
ears, behind the head (occipital), or in the back of the upper neck. Headache,
like chest pain or dizziness, has many causes. There are two types of headaches:
primary headaches and secondary headaches. Primary headaches are not associated
with (caused by) other diseases. Examples of primary headaches are
migraine
headaches, tension headaches, and cluster headaches. Secondary headaches are
caused by associated diseases such as
brain tumors,
strokes,
meningitis,
subarachnoid hemorrhages, caffeine withdrawal, or discontinuation of analgesics.
In rare occasions, headaches may signal
heart attacks.
Establishing the diagnosis of the headache, arriving at effective treatment(s)
for the headache, and taking measures to prevent or reduce headache episodes
will require cooperation between you and your doctor. Following are
suggestions on how to work with your doctor in diagnosing and managing your
headaches.
How Can I Help My Doctor?
Pay attention to your symptom(s) so you can describe your condition as
accurately as possible:
- What are your headache location, duration, severity (worst ever
headache?), and character (dull, sharp, throbbing, etc.)?
- What brings them on (for example, certain foods, stress, bright light,
fasting, or sleep disturbances)?
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What is a headache?
Headache is defined as pain in the head or upper neck. It is one of the most
common locations of pain in the body and has many causes.
How are headaches classified?
Headaches have numerous causes, and in 2007 the International Headache Society
agreed upon an updated classification system
for headache. Because so many people
suffer from headaches, and because treatment is sometimes difficult, the new
classification system allows health care practitioners to understand a specific diagnosis
more completely to provide better and more effective treatment regimens.
There are three major categories of headaches:
- primary headaches,
- secondary headaches, and
- cranial neuralgias, facial pain, and other headaches
What are primary headaches?
Primary headaches include migraine, tension, and cluster headaches, as well
as a variety of other less common types of headache.
Tension headaches are the most common type of primary headache; as many as
90% of adults have had or will have tension headaches. Tension headaches are
more common among women than men.
Migraine headaches are the second most common type of primary headache. An
estimated 28 million people in the United States (about 12% of the population)
will experience migraine headaches. Migraine headaches affect children as well
as adults. Before puberty,
boys and girls are affected equally by migraine headaches, but after puberty,
more women than men are affected. An estimated 6% of men and up to 18% of women
will experience a migraine headache.
Cluster headaches are a rare type of primary headache, affecting 0.1% of the
population. An estimated 85% of cluster headache sufferers are men. The average
age of cluster headache sufferers is 28-30 years of age, although headaches may begin
in childhood.
Primary headaches affect quality of life. Some people have occasional
headaches that resolve quickly, while others are debilitated. Tension, migraine,
and cluster headaches are not life-threatening.
What are secondary headaches?
Secondary headaches are those that are due to an underlying structural
problem in the head or neck. There are numerous causes of this type of headache
ranging from bleeding in the brain, tumor, or
meningitis and encephalitis.
Next: What are cranial neuralgias, facial pain, and other headaches? »
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Concussion »
What is concussion and what causes concussion?
Mild traumatic brain injury, or concussion, can be defined as a short-lived
loss of brain function due to head trauma that resolves spontaneously. With
concussion, function may be interrupted but there is no structural damage to the
brain.
The brain floats in cerebrospinal fluid and is encased in the skull. These
protections allow it to withstand many of the minor injuries that occur in day
to day life. However, if there is sufficient force to cause the brain to bounce
against the rigid bones of the skull, then there is potential for injury. It is
the acceleration and deceleration of the brain against the inside of the skull
that can cause the brain to be irritated and interrupt its function. The
acceleration can come from a direct blow to the head or face, or from other body
trauma that causes the head to shake. While temporary loss of consciousness due
to injury means that a concussion has take...
Read the Concussion article »
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