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?
A Headache is defined as a 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 sometimes is difficult, it is hoped
that the new
classification system will allow health care practitioners come to a specific diagnosis
as to the type of headache and to provide better and more effective treatment.
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. Up to 90% of adults have had or will have tension headaches. Tension headaches
occur
more commonly 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 a migraine headache. 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. It is estimated that 6% of men and up to 18% of women
will experience a migraine headache in their lifetime.
- Cluster headaches are a rare type of primary headache affecting 0.1% of the population (1 in a 1,000 people). It more commonly affects men in their late 20s though women and children can also suffer these types of headache.
Primary headaches can affect the quality of life. Some people have occasional headaches that resolve quickly while others are debilitated. While these headaches are not life-threatening, they may be associated with symptoms that can mimic strokes or intracerebral bleeding.
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.
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