There are many different types of headaches, all with different characteristics and some with specific causes. It is thought that most headaches are not "just a headache", but are a brain disorder. During the past year, nearly 90% of men and 95% of women have had at least one headache.
1. Primary headaches include tension-type, migraine, and cluster headaches and are not caused by the underlying medical conditions. More than 90% of headaches are primary.
2. Secondary headaches result from other medical conditions, such as infection or increased pressure in the skull due to a tumor. These account for fewer than 10% of all headaches
The following is brief information about some of the common headache types.
Tension-type headache
Tension type headaches are the most common, affecting upwards of 75% of all headache sufferers.
Migraine
Migraine headaches are less common than tension-type headaches. Nevertheless, migraines afflict 25 to 30 million people in the United States alone.
Columns A and B show the symptoms commonly seen in two types of headache. Compare your symptoms with those listed and determine what type of headache you may have by noting whether your symptoms are most like those in column A or B. Some people have both of these types of headache. If your headache are very severe or if you think they are some other type, do not delay in seeking professional medical attention.
| Symptom | A Tension |
B Migraine |
| Intensity and Quality of Pain | ||
| Mild-to-moderate | • | • |
| Moderate-to-severe | • | • |
| Intense, pounding, throbbing and/or debilitating | • | |
| Distracting but not debilitating | • | |
| Steady ache | • | |
| Location of Pain | ||
| One side of head | • | |
| Both sides of head | • | • |
| Associated Symptoms | ||
| Nausea/vomiting | • | |
| Sensitivity to light and/or sounds | • | |
| Aura before onset of headache such as visual symptoms | • | |
| Note: Rebound headache may have features of tension and/or migraine headache | ||
|
Cause |
Notes |
| Analgesic rebound headache | OTC analgesics, ergotamine preparations, other nonnarcotic and narcotic pain medicines |
| Headache secondary to caffeine or artificial sweeteners | Coffee, tea, or sodas containing caffeine or aspartame |
| Headache secondary to medications | Variable-do not self-diagnose this problem |
| Headache secondary to other diseases | Chronic infection, nasal sinus disease, & others |
| Headache secondary to depression | Particularly if the depression preceded the headache |
| Chronic tension-type headache | When there is no overuse of analgesics |
| Chronic post-traumatic headache | When there is no overuse of analgesics |
Hemicrania continua |
A very rare condition diagnosed when all other causes are excluded |
New Daily Persistent Headache
New Daily Persistent Headache (NDPH) has been recognized as a distinct primary headache syndrome. Primary headache disorders are those for which there is no underlying secondary cause that can be identified. As with Migraine disease and some other headache disorders, there are several secondary conditions that can mimic NDPH, so they must be ruled out before a diagnosis of NDPH can be confirmed. Two conditions in particular that must be ruled out are spontaneous cerebrospinal fluid (CSF) leak and cerebral venous sinus thrombosis. Headache from a spontaneous CSF leak is usually affected by body position, but the longer it continues, the less apparent that becomes. Therefore, patients may not think to mention that their headache was, at one point, affected by body position, and that maybe missed. Other conditions that have to be considered before making the diagnosis of primary NDPH are chronic meningitis, post-traumatic headache and intracranial hypertension.
To be diagnosed as NDPH, headache must last more than three months and be daily from within three days of onset. It is bilateral, has a pressing/tightening (non-pulsing) quality, is mild to moderate in intensity, and is not aggravated by routine physical activity.
82% of patients knew the exact day their headache started.
In 30% of the patients, the onset of the headache occurred in correlation with an infection or flu-like illness.
38% of patients had a prior personal history of headache.
29% of patients had a family history of headache.
Accompanying symptoms:
68% reported nausea.
66% reported photophobia.
61% reported phonophobia.
55% reported lightheadedness.
Imaging and laboratory testing was unremarkable except for an unusually high number of patients who tested positive for a past Epstein-Barr virus infection.