Medical Author: William C. Shiel Jr., MD, FACP, FACR
A headache (medically termed cephalgia) is a pain in the head. Headaches can be located anywhere in the head, including above the eyes or the ears, behind the head (occipital headache), the top of the head (coronal headache), or in the back of the upper neck. Headache, like chest pain or backache, has many causes.
All headaches are considered primary headaches or secondary headaches. Primary headaches are not associated with other diseases. Examples of primary headaches are migraine headaches, tension headaches, and cluster headaches. Secondary headaches are caused by other diseases. The associated disease may be minor or major.
Headaches can be associated with symptoms such as
- pain in the eyes when looking into bright lights (photophobia),
- tenderness of the scalp,
- tightness sensation in the head, and
There are many types of headaches. Tension headaches are the most common type of primary headache. As many as 90% of adults 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 U.S. have 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 have them. Migraine often goes undiagnosed or is misdiagnosed as tension or sinus headaches.
Cluster headaches are a rare but important type of primary headache, affecting mainly men. The average age of cluster headache sufferers is 28-30 years of age, although headaches may begin in childhood.
Secondary headaches may result from innumerable conditions, ranging from life-threatening ones such as brain tumors, strokes, meningitis, vasculitis, and subarachnoid hemorrhages to less serious but common conditions such as withdrawal from caffeine, sinus infection (sinusitis), and discontinuation of analgesics (painkilling medication). Pregnancy sometimes causes headaches. Many people suffer from "mixed" headache disorders in which tension headaches or secondary headaches may trigger migraine.
The treatment of the headache depends on the type and severity of the headache and on other factors, such as the age of the patient.
Kasper, D.L., et al., eds. Harrison's Principles of Internal Medicine, 19th Ed. United States: McGraw-Hill Education, 2015.
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Other Causes of Headache
- Bacterial Infection (Inside or Outside of the Head)
- Cluster Headache
- Cold Drink or Food ("Brain Freeze")
- Compression of Head (Hat, Helmet, etc.)
- Illicit Drug Withdrawal
- Intracranial Hemorrhage
- Medications (Both Prescription and Nonprescription)
- Sexual Activity
- Trauma Injury to Head or Neck
- Viral Infection (Inside or Outside of the Head)
Examples of Medications for Headache
- acetaminophen (Tylenol, Tylenol Arthritis Pain, Tylenol Ext, Little Fevers Children's Fever/Pain)
- amitriptyline (Elavil, Endep)
- aspirin (acetylsalicylic acid, Bayer, Ecotrin, and others)
- Birth Control Pills (List of Oral Contraceptives and Side Effects)
- Calcium Channel Blockers (CCBs)
- gabapentin (Neurontin, Gralise, Horizant, Fanatrex FusePag) Side Effects, Dosage, and Abuse
- ibuprofen (Advil, Children's Advil/Motrin, Medipren, Motrin, Nuprin, PediaCare Fever, and others)
- naproxen (Aleve, Anaprox, Naprelan, Naprosyn)
- nortriptyline, Pamelor, Aventyl - has been discontinued in the U.S.
- OTC Pain Relievers and Fever Reducers
- propranolol, Inderal, Inderal LA, Innopran XL
- sumatriptan, Imitrex, Alsuma, Imitrex STATdose System, Sumavel DosePro
- tacrolimus (Prograf, Astagraf XL, Envarsus XR)
- valproic acid, divalproex, Depakote, Depakote Sprinkle, Depakote ER, Depakene, Depacon, Stavzor
- Zecuity (sumatriptan iontophoretic patch)
- zolmitriptan, Zomig, Zomig-ZMT
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