There are many different types of headaches, ranging from being medically benign to being a medical emergency. This article is designed as a guide only, it should not be used to diagnose and treat types of headaches. If you have a problem with headaches you should speak with your doctor to receive a proper diagnosis. Headaches are often a side effect of medications. If you have started or stopped a medication recently and you are having headaches, speak with your doctor.

Because of the varying nature, causes and treatment for the different types of headaches each type will be listed separately. Please note that the problems and complications for headaches may not apply to each type of headache.

Headaches can cause the following problems and complications:

- Nausea and/or vomiting
- Difficulty concentrating
- Vision disturbances
- Sensitivity to light and/or sound
- Vertigo (balance problems)
- Memory problems

Primary Headaches – Primary headaches are headaches that are the primary problem.

Tension – Unknown cause. Tension headaches usually affect both sides of the head or neck, but it may only affect one area. Tension headaches often cause pressing or tightening pain of mild to moderate intensity. They come on gradually and can last for minutes to days. Sometimes there is also light and sound sensitivity with tension headaches.

Migraine – Thought to be caused by imbalance of excitatory and inhibitory neurotransmitters that affect craniovascular modulation. (The chemicals in the brain cause the blood vessels to react funny). Migraines usually affect only one side of the head, but sometimes can affect both sides. Migraines often cause throbbing or aching pain that is variable in severity. They come on rapidly and can last from 4 to 72 hours.

People with migraines often also have nausea, vomiting, light and sound sensitivity, and they may have either visual or motor auras. Migraines are often triggered by specific things that vary from person to person.

Cluster – Possibly caused by blood vessels that are dilated (expanded) when they are not supposed to be. Cluster headaches almost always affect one side of the head, with pain behind or around the eye on that side. The pain is usually deep, continuous and severe. They come on very quickly and can last up to 3 hours. Often someone with cluster headaches will get multiple headaches in a short period of time.

Cluster headaches may cause excessive eye watering, or nasal drainage, sensitivity to light, difficulty focusing, drooping of the eye lid or swelling around the eye.


Secondary Headaches – Secondary headaches are headaches that are caused by or a symptom of another underlying problem.

General Secondary Headache – These headaches are caused by varying problems, such as fever, hypoxia (low oxygen), carbon monoxide poisoning, or caffeine withdrawal. They generally affect the whole head, but may be limited to one side. They are treated by fixing the underlying problem.

Analgesic Rebound – These headaches are caused by withdrawal of medications taken to treat a headache. They often mimic the previous headache and vary in severity. They appear once the medication begins to wear off.

Headaches from Eye Disorders – These headaches are caused by strain to the muscles that control the eye. They occur around and over the eyes, and may radiate out from the eyes. They have a steady, aching dull pain. They come on gradually and may last until the problem is resolved.

Headaches from eye disorders may cause the eyes to feel fatigued or “sandy” and the eyes may also be red.

Sinusitis – These headaches are cause by inflammation of the sinuses, also called “Sinus Headaches”. They are located over the sinuses (approximately under the forehead and cheek bones). They are aching or throbbing and vary in severity. The onset depends on the onset of the illness, and they may last for hours to days depending on the severity of the Sinusitis.

These headaches may also have local tenderness over the sinuses, nasal congestion and/or discharge and fever.

Meningitis Headache – Meningitis is an infection of the meningies, which are the lining that surrounds the brain. These headaches are generalized, and are steady, throbbing and very severe. The onset is rapid and they may last from hours to days.

Someone with meningitis with also be generally ill, and have a fever and a stiff neck, or neck tenderness. Meningitis is a life threatening condition and if someone is suspected of having meningitis they need to be seen at a Hospital as soon as possible.

Posttraumatic Headache – Caused by trauma to the head. May be limited to the area injured, but can affect the whole head. The pain is generalized, dull, aching and constant. These headaches can occur within hours to 1-2 days after an injury. They may last from days to years depending on the injury.

Anyone who has a headache after being hit in the head, or injuring their head needs to be checked out by a doctor to make sure there is no internal injury to the brain, such as bleeding or swelling.

Subarachnoid Hemorrhage Headache – Caused by bleeding under the protective layer of the brain. These are often caused by a ruptured aneurysm. They are generalized and are very severe to the point where the person may be unable to function because of the pain. The onset is very rapid and the headache will last until the problem is corrected.

Someone who has a subarachnoid headache may exhibit the signs of a stroke (Drooping face, weakness on one side of the body, difficulty speaking). They may become unconsciousness, have nausea, vomiting and/or neck pain.

Cranial Neuralgias – Caused by compression of cranial nerve 5. These headaches affect the cheeks, jaws, lips and/or gums. The pain feels like electrical shocks or burning and may be severe. The onset is sudden and it may come and go very quickly, with the pain only lasting for seconds at a time. These may last for months until the compression is relieved.


Treatment

Tension – Massage, relaxation, muscle relaxant medications.

Migraines – Avoid triggers, quiet dark rooms, sleeping, over the counter pain medication, and there some prescription medications you can speak to your doctor about.

Cluster – Avoid overstimulation, over the counter pain medications may sometimes be helpful.

General Secondary Headache – Treat the underlying cause.

Analgesic Rebound – Treatment depends on cause of original headache.

Headaches from Eye Disorders – It is important to get an eye exam to determine if eye glasses are necessary. Modifying work environments may also help (eliminating flickering lights, breaks from work that stresses the eye). Over the counter pain medication may be helpful.

Sinusitis – Nasal decongestants and antibiotics.

Meningitis – This is a medical emergency and if meningitis is suspected the person should be brought to the hospital immediately for treatment.

Posttraumatic – Anyone who develops a headache after experiencing trauma to the head needs to get checked out by a doctor as soon as possible to rule out a closed head injury or brain damage.

Subarachnoid Hemorrhage Headache – These headaches are a medical emergency, if someone has the symptoms of a subarachnoid hemorrhage they need to be seen at a hospital immediately and should be transported by ambulance.

Cranial Neuralgias – Anyone exhibiting the symptoms of this should be seen by a doctor so that the compression on the nerve can be relieved.

Call an ambulance if someone has a headache and:

- Blindness occurs.
- They have weakness or paralysis on one side, difficulty speaking, or facial droop.
- They have a decreased level on consciousness.
- They are having difficulty breathing or chest pain.
- They have a fever and their neck is stiff or painful to move.


DO speak with your doctor if you are having headache problems.
DO chart your headaches by writing down when you get them, what they feel like and how severe they are. This will help when you speak with the doctor.

DO NOT drive if you are having difficulty concentrating or vision disturbances.
DO NOT take aspirin for a headache.
DO NOT take medication that is not prescribed for you.
DO NOT ignore a headache that lasts more than 24 hours.

What to expect at the doctors or hospital:

What to expect varies greatly on the type of headache you are having. Generally they will try and determine the type of headache and then prescribe a treatment. Diagnosing the type of headache may be as simple as asking some questions to determine what is going on. They may draw blood to check your medication, or electrolyte levels. They may also do a cat scan, MRI or EEG of your brain in severe cases. These are all just fancy picture taking devices that can take a picture of your brain. The doctor may give you medication to help with the headaches, or refer you to see a specialist doctor if you need further care.