46 Types of Headaches – Symptoms, Causes and Treatment

Headache is the pain felt in the head or neck due to a problem arising in soft tissues, blood vessels, or nerves in the area. Different types of headaches present with different signs and symptoms in different locations depending upon the triggers and causes. It is very important to diagnose the exact cause of the headache and treat it before the headache takes a chronic form. Given below is a list of 46 different headaches, in alphabetical order, along with their symptoms, causes, and treatment:

1. Alcohol Headache
2. Altitude Headache
3. Arthritis Headache
4. Caffeine Headache
5. Cervicogenic Headache
6. Chinese Restaurant Syndrome
7. Chronic Daily Headache
8. Cluster Headache
9. Cough Headache
10. Dehydration Headache
11. Depression and Headache
12. Exercise Headache
13. External Compression Headache
14. Eye-strain Headache
15. Fasting Headache
16. Headache after Eating
17. Headache as a key symptom of Brain Aneurysm
18. Headache after Nap
19. Headache and Cold
20. Headache due to Lack of Sleep
21. Headache due to Low Pressure
22. Headache due to Noise
23. Headache during Pregnancy
24. Headache during Sex
25. Hormone Headache
26. Headache due to smoking
27. Hypertension Headache
28. Hypnic Headache
29. Hypotension Headache
30. Ice-pick Headache
31. Medication overuse Headache
32. Migraine
33. New Daily Persistent Headache
34. Occipital Neuralgia
35. Orthostatic Headache
36. Paroxysmal Hemicranias
37. Post-Traumatic Headache
38. Sinus Headache
39. Spinal Headache
40. SUNCT Syndrome
41. Tension Headache
42. Thunderclap Headache
43. TMJ Headache
44. Trigeminal Autonomic Cephalgias
45. Trigeminal Neuralgia
46. Vestibular Migraine

1. Alcohol Headache

People who drink Alcohol or Alcohol containing beverages often complain of Headaches with the Hangover that follows the next morning. This headache is also known as Alcohol Headache.

Symptoms:

• Nausea
• Increased thirst
• Photophobia and phonophobia
• Loss of coordination and attention
• Visual symptoms like blurred vision.

Causes:

• Alcohol contains Histamine which causes inflammation in the body and provokes the immune system to make more histamine that results in excessive inflammation that runs throughout the body.
• Red wine increases the Serotonin levels which trigger a migraine attack.
• Vasodilation in skull and brain vessels is one reason for Headache.

Treatment:

• Anti-inflammatory substances block the production of enzymes that cause headaches.
• N-acetyl cysteine reduces the effect of Alcohol on the Liver.
• Vitamin B6 help gets rid of Alcohol faster from the body.

2. Altitude Headache

Altitude Headache develops along with nausea, dizziness, and other symptoms when an altitude, as high as 8500 feet above sea level is reached. Around one-fourth of those who ascend mountains, develop this headache also known as Acute Altitude sickness Headache.

Symptoms:

• Loss of consciousness
• Fatigue and general Lethargy
• Headache that aggravates upon exertion
• The intensity ranges from mild to moderate and moderate to severe as the altitude increases
• Cerebral edema rarely occurs
• Loss of appetite
• Facial flushing
• Shortness of breath.

Causes:

As the altitude increases the atmospheric pressure decreases causing the decreased amount of oxygen entering the lungs and general state of hypoxia. Hypoxia develops a headache, as enough nourishment does not reach the brain tissues. Another cause is excessive vasodilation in the vessels of the scalp and brain that takes place as a result of hypoxia.

Treatment:

• Headache can be relieved by taking Ibuprofen, aspirin.
• In some cases, furosemide and acetazolamide have also proven to be effective.
• Acetazolamide is especially helpful for trouble sleeping.

3. Arthritis Headache

Headache is a very commonly observed problem among several others in people who have Arthritis if it involves cervical vertebrae. The two most common causes of Arthritis Headache are Osteoarthritis and Rheumatoid Arthritis.

Symptoms:

• Severe pain at the back of head and neck
• Neck stiffness
• Inflamed, and swollen joints
• Neurological signs if a nerve is involved
• Numbness and tingling.

Causes:

Arthritis results in degenerative changes in the joint that leads to the formation of bony spurs that make any sort of movement at the joint almost impossible. Constant friction leads to severe pain that radiates to the head and causes Arthritis Headache. It most commonly involves the fifth, sixth, and seventh vertebrae in the neck.

Treatment:

• DMARDs are prescription medication for Arthritis.
• Anti-inflammatory medicine such as NSAIDs can be used to lower the inflammation.
• Physiotherapy is required if a nerve is involved and neurological symptoms present.

4. Caffeine Headache

People who drink excessive amounts of coffee suffer from a Caffeine Headache when they miss their regular cup at their usual time. The Caffeine Headache is a withdrawal symptom.

Symptoms:

• Irritability
• Low mood and low energy levels
• General lethargy
• Constipation
• Tremors (in severe cases).

Causes:

Caffeine constricts the blood vessels of your brain. As its effects fade off, the blood vessels tend to dilate, directing blood flow towards the brain and cause a Headache.

Treatment:

• Over the counter analgesics: to help with the pain.
• Over the counter pain killers, containing caffeine: Excedrin.
• Cold compresses can also relieve tension and pain due to headaches by reducing the inflammation.
• Drink a lot of fluids to combat dehydration.

5. Cervicogenic Headache

Cervicogenic Headache is caused by any sort of problem that arises in the root of the neck. The pain begins in the neck radiating towards the back of head and then in the whole head.

Symptoms:

• Neck stiffness
• Pain in the back of head, on one side of the head and face.
• Headache associated with certain neck positions and posture.
• Numbness and tingling.

Causes:

The problem might be as insignificant as a bad posture, falling asleep on high pillows, or long tiresome working hours to a whiplash injury to the cervical spine, disc herniation, osteoarthritis to name a few. The pain felt is basically due to a pinched nerve in the neck region that supplies the areas affected by it.

Treatment:

• Over the counter analgesics: ibuprofen, acetaminophen to relieve pain.
• Muscle relaxant: to ease the taught muscles.
• Anti-inflammatory drugs: NSAIDs to help release the inflammation.
• Corticosteroids: The doctor might suggest injecting a corticosteroid.

6. Chinese Restaurant Syndrome

There are a small fraction of people who have a sensitivity to food additive; MSG, suffers from a group of symptoms namely; Headache, Flushed skin, and excessive sweating known as Chinese Restaurant Syndrome or MSG Symptom Complex.

Symptoms:

• A severe headache
• Facial flushing and swelling
• Excessive sweating
• Increased heart rate
• Arrhythmias
• Chest pain
• Difficulty in breathing.

Causes:

MSG is made from glutamic acid by fermentation of starch, molasses, or sugarcane. People who are sensitive to MSG, experience an allergic reaction upon consumption of any such food that contains this additive. Several studies have been conducted which consider MSG Symptom Complex as just a hypersensitive reaction experienced by only those who are extremely sensitive to MSG.

Treatment:

The treatment entirely depends upon the severity and type of symptoms experienced by each individual. Most of the time no treatment is required.

7. Chronic Daily Headache

Having more than 15 episodes of headache in a month for a consecutive period of three months is classified as Chronic Daily Headache. People who have Tension Headaches or Migraines are more prone to develop a chronic condition.

Symptoms:

The symptoms of Tension Headache or Migraine are seen.

Causes:

If the Headache is left untreated and remains undiagnosed it takes a more chronic form.

Treatment:

Prophylactics for the initial cause of the headache may help reduce the rebound headaches.

8. Cluster Headache

Cluster Headache occurs in a cyclic pattern and is episodic in nature. One may experience either one or several attacks of sharp pain in front of the head, within a 24 hour period.

Symptoms:

• Watery or Swollen eyes
• Nasal congestion and discharge
• Sharp pain in the head behind eyes.

Causes:

The abnormal hypothalamic activity has been recorded in patients with Cluster Headaches.

Treatment:

• Subcutaneous injections of sumatriptan
• Inhalation of 100 percent oxygen
• Lithium therapy can help patients with severe chronic clusters.

9. Cough Headache

A Cough Headache typically lasts a few seconds to a few minutes with an abrupt onset. A dull pain may last for 2 hours and is caused by any sort of straining for example cough, sneeze, blowing the nose, etc.

Symptoms:

• Usually sharp and stabbing in character.
• Affects both sides of the head but can also occur on one side.
• Has an abrupt onset and it goes away within a few minutes.
• The intensity of pain ranges from moderate-to-severe.
• Blurred vision
• Loss of coordination
• Unconsciousness.

Causes:

Cough headache with the primary cause is due to the pressure in the chest and abdomen that increases when you cough, this also increases the pressure in the brain resulting in a headache.

Treatment:

• Indomethacin: relieves inflammation.
• A spinal tap can also be done to decrease the pressure around the brain.

10. Dehydration Headache

Dehydration Headache only occurs when the body is dehydrated and is typically felt on both sides of the head.

Symptoms:

• Severe throbbing headache
• Dry mouth and cracked lips
• Dizziness
• Dark-colored, concentrated Urine.
• Loss of skin elasticity
• Sunken eyes
• High Heart rate, Low blood pressure
• Unconsciousness.

Causes:

As the amount of liquid leaving the body exceeds water intake, the body becomes dehydrated and cause severe Brain damage. This leads to a headache.

Treatment:

• Oral Rehydration Serum, such as Pedialyte, is the best treatment for a Dehydration Headache.
• An OTC painkiller can help with the headache.
• An IV solution of Ringer lactate might be given in case of excessive fluid loss.

11. Depression and Headache

Around 80% of adults all over the world experience tension headaches throughout their life and most of them suffer from mental health illnesses like anxiety and depression. This shows a strong association between Depression and Headache.

Symptoms:

• Headache can be pulsating, throbbing, dull, or radiating in character
• Worsens with physical activity
• Headaches are rebound and more than 3 episodes occur in a week, each episode lasting for longer than 2 hours.
• Low mood
• Neck stiffness and back pain
• Joint and body aches
• General Lethargy and weakness
• Irritability
• Eating disorders
• Poor Sleep.

Causes:

The primary cause of Depression-induced headaches is usually stress and anxiety along with genetic and environmental factors. Studies suggest that an imbalance of chemicals such as serotonin and dopamine is responsible for the coexistence of Depression and Headache Disorders like a migraine.

Treatment:

• Tricyclic antidepressants
• Selective serotonin reuptake inhibitors
• Over the counter painkillers for temporary relief
• Ketamine infusions for Mood disorders.

12. Exercise Headache

Exercise Headache is triggered by some sort of physical activity and is divided further into two categories: Primary Headache and Secondary Headache.

Symptoms:

• Blurred vision
• Lethargy
• Congestion
• Neck stiffness.

Causes:

Vasodilation that occurs to meet oxygen requirements of the scalp, brain, and Head while woking out is responsible for the headache.

Treatment:

• Indomethacin is the most commonly prescribed drug for an Exercise Headache.
• Staying hydrated during the exercise.
• Taking plenty of fluid before and after the workout.
• Energy drinks contain high amounts of electrolytes.

13. External Compression Headache

People who wear a certain type of headwear such as goggles or helmets, continuously, often develop External Compression Headache due to continuous pressure. This is also known as Goggle Headache or a Helmet Headache.

Symptoms:

A study, pressing pain that aggravates with the use of headwear. However, Compression Headache can turn into a Migraine as a result of a longer duration of exposure, in such cases, the symptoms of migraine will present.

Causes:

Headwear can exert pressure on nerves externally, just under your scalp, causing External Compression Headache. The pain receptors transmit sensations from the face or head to the brain or to the nerves in the back of the head which causes a headache. The most commonly involved nerves are Trigeminal and occipital nerves.

Treatment:

• An over the counter analgesic for pain relief.
• Excedrin or Sumatriptan for migraine.

14. Eye-strain Headache

The eyes get tired due to the overuse of computer screens and trigger an Eye-strain Headache.

Symptoms:

• Blurred vision
• Dry or watery eyes
• Redness of eyes
• Burning and itching in the eyes
• Loss of focus.

Causes:

Eye Strain Headache or Asthenopia is mostly caused due to:

• Being exposed to bright lights
• Driving for too long
• Reading without taking rest
• Being stressed out and fatigued causing tension headache
• Using digital devices for long hours.

Treatment:

• Over the counter, analgesics can be taken such as Aspirin, Acetaminophen, and Ibuprofen.
• Natural tears can be used as a lubricant for dry eyes.
• Muscle relaxants for fatigue.

15. Fasting Headache

People who choose Intermittent Fasting to lose weight tend to get frequent Fasting Headache that begins after 14 to 16 hours of fasting as the body starts going into a hypoglycemic state and lasts as long as 72 hours in most conditions.

Symptoms:

• Nausea and Dizziness
• Tremors
• Loss of coordination
• Low mood and Energy levels.

Treatment:

Over the counter Analgesics: Acetaminophen, Aspirin, Ibuprofen can help.
Oral Rehydration Solution: can overcome the electrolyte depletion very fast.

16. Headache after Eating

Some headaches are triggered or caused by consuming certain foods, this can indicate an underlying condition. Headache after Eating is also known as Postprandial Headache and can be caused by a number of things and may vary in pattern.

Symptoms:

• Headache after eating can be throbbing, aching, gripping, or pulsating in character.
• May be accompanied by Nausea in case of severe Headache.
• May range from dull to severe in intensity.
• Associated Auras in case of a Migraine may accompany.

Causes:

• Occurs in response to reactive hypoglycemia or postprandial hypoglycemia. A drop in blood glucose levels that occurs within 4 hours of eating can trigger a headache.
• Due to food allergies.
• Individuals who get chronic migraine attacks can also experience Headaches after Eating the trigger food. Some of these foods include MSG containing processed foods, aged cheese, Red wine, soy sauce, and alcohol.

Treatments:

• An over-the-counter analgesic for pain relief, if the headache does not go away itself.
• In case of food allergies, take an antiallergic.

17. Headache as a key symptom of Brain Aneurysm

Patients often present with severe Headache as the Key symptom of Brain Aneurysm, among many others. An aneurysm can leak, rupture, or enlarge, worsening the symptoms respectively, and might become a dangerous situation for the patient.

Symptoms:

• Symptoms depend upon the status of the Aneurysm, either it is ruptured or unruptured, leaking or not.
• Headache sudden in onset is the key symptom of a ruptured aneurysm along with Severe pain like a Thunderclap Headache, Nausea and vomiting, and Blurred vision and photophobia.
• If the aneurysm has not ruptured, it may exist without any symptoms. Therefore if it is large in size and presses on surrounding nerves and brain tissues.
• Severe Rupture is often followed by a leaking aneurysm, the only Symptom experienced is the Sudden onset of a severe, debilitating headache.

Causes:

An aneurysm generally develops in the form of a dilation where the vessel wall has become too thin and lost its elasticity. There are a number of factors that can lead to weakness of the arterial wall thus, increasing the risk for a brain aneurysm or worse an aneurysm rupture to occur.

Treatment:

• The treatment entirely depends upon the status of the Aneurysm.
• Flow diversion that includes tubular stent-like implants that are used to divert the blood flow away from the Aneurysm.
• Endovascular coiling is a similar technique in which a catheter is inserted through a blood vessel elsewhere in the body that carries a coiled tube that lodges at the Aneurysm and blocks the blood flow from the artery.

18. Headache after Nap

A lot of people with Headache after Nap report that Headache is so intense that it becomes debilitating. Sleep and headache are linked because some parts of the brain control both.

Symptoms:

• Nausea
• Anorexia
• Stress and Anxiety
• Body aches and general lethargy
• Dizziness.

Causes:

• People who do not follow a proper sleeping schedule and stay up for most of the night, often wake up with a headache.
• Insomnia is the most common sleeping disorder in people who have frequent migraines.
• Hypnic Headache is a rare condition that exclusively occurs during the night when you’re asleep, waking you up from a good night’s sleep.

Treatment:

Each cause is to be treated individually to avoid headache. For that, your underlying cause must be identified and diagnosed by a healthcare professional.

19. Headache and Cold

Cold is a very common illness experienced by most adults around two to four times on average, in a year. Headache is also experienced at some point during the cold but gets neglected, most of the time. Thus no direct association between Headache and Cold is observed

Symptoms:

• Runny or congested nose
• Watery eyes
• Fever
• Nausea and vomiting
• Chills
• Excessive sneezing and cough.

Causes:

During an episode of the cold, the immune system produces inflammatory molecules, called cytokines, to fight against the infection. The cytokines can sometimes cause inflammation which results in Headache during Cold.
Inflammation of paranasal sinuses can cause the pressure in the sinuses to increase so much that it causes pain in the cheeks, in the forehead, and behind the eyes.

Treatments:

• Over the counter, analgesics can help relieve the pain.
• Nasal decongestants can be given for a stuffy nose.
• Antibacterial can be given for bacterial infection.
• In the case of allergic sinusitis, an anti-allergy can prove helpful.

20. Headache due to lack of sleep

Headaches and sleep have been related for decades. Waking up with a Headache is one major sign that you did not get enough sleep. Headache due to lack of sleep is often presented with other symptoms as well.

Symptoms:

• Headache in the back, forehead, and top of the head
• Fatigue
• Mild Nausea
• Photophobia and phonophobia
• Low mood and Irritability
• Dizziness.

Causes:

• The formation of proteins in the body that causes chronic pain due to lack of sleep. These proteins work by lowering the body’s pain threshold thus, sparking intense migraines and headaches.
• When a body is deprived of sleep, it produced certain inflammatory markers that slowly revert when you start getting enough sleep. These stress and inflammatory markers cause Headaches due to lack of Sleep.

Treatment:

• Analgesics: aspirin, acetaminophen, ibuprofen.
• Antiemetics: chlorpromazine, metoclopramide.

21. Headache due to Low Pressure

The brain is supported and cushioned from its surroundings by Cerebrospinal fluid which is constantly made and absorbed to maintain the spinal fluid volume and pressure normal. A decrease in spinal fluid leads to (Spontaneous Intracranial Hypotension) SIH Headache, also known as Headache due to Low Pressure.

Symptoms:

• Photophobia and phonophobia
• Tinnitus
• Nausea
• Dizziness
• Vomiting
• Diplopia
• Neck pain.

Causes:

• Any change in volume or pressure of Cerebrospinal Fluid can cause a headache. SIH Headache is spontaneous in onset and is caused due to low pressure exerted by the cerebrospinal fluid.
• Decreased pressure can cause sagging of the brain in the cranial cavity, causing traction on cranial nerves and other structures like vessels which might be the cause of Orthostatic headache.

Treatment:

• IV infusion: If a patient is unable to consume a lot of fluid by the oral route, intravenous fluids are given to raise the pressure.
• Analgesics: Severe Acute pain can be treated by giving analgesics.

22. Headache due to Noise

Noise is the most commonly observed headache trigger, Chronic migraine sufferers are very easily triggered due to even slightly loud noises. People who do not suffer from any headache condition also develop Headache due to noise, after being exposed to loud surroundings.

Symptoms:

• Nausea
• Sensitivity to light
• Hypersensitivity to different smells
• Sleeping disturbances.

Causes:

People with frequent headaches have a lesser threshold for the endurance of sound and are more likely to develop a Headache due to noise.

Treatment:

• For pain relief: Aspirin, Acetaminophen.
• Desensitization: Gradual exposure to the trigger can help increase your threshold against the trigger.

23. Headache during Pregnancy

A Headache during Pregnancy can mean a lot of things and is a common problem experienced by pregnant women among other issues.

Symptoms:

• Headache is mostly Throbbing, Pulsating, or Aching in character.
• The intensity may vary from dull to severe.
• Other symptoms are dependent upon the type of headache experienced e.g Cluster, Tension, or Migraine.

Causes:

The hormonal changes that take place in the mother’s body along with other causes such as Dehydration, Hypertension, and drastic weight changes can trigger a Headache. However, the causes may vary in each Trimester.

Treatment:

• You can take a low dose of Paracetamol (Tylenol).
• Some doctors also recommend taking a small dose of Aspirin.
• Other than that underlying cause is treated.

24. Headache during Sex

Some people experience a dull headache that increases as the sexual excitement increases during Sex. Most of the time, Headache during Sex is just due to exertion but can also indicate a secondary cause.

Symptoms:

Dull pain in the head and neck that increases in intensity or a sudden onset of severe pulsating headache is experienced at the time of climax during sexual intercourse.

• Nausea
• Vomiting
• Neck stiffness
• Muscle weakness.

Causes:

The pain is just triggered as a result of sexual activity that causes muscles in the neck and head to get stretched which is the cause of the pain. However, Headache during Sex that is abrupt in onset is mostly associated with:

• Increased blood flow to the brain caused by sexual arousal.
• Rupture of an Intracranial aneurysm.
• Arteriovenous malformation that causes leakiness of blood from vessels into the CSF that surrounds the brain.
• Inflammation caused due to certain infections.

Treatment:

• Indomethacin is given for inflammation.
• Beta-blockers and other antihypertensive are given to lower blood pressure towards the brain.

25. Hormone Headache

Hormone Headache is related to the changes in hormone levels over the cycle and they affect Women all around the World.

Symptoms:

• Constipation
• Loss of appetite
• Nausea
• Lower Body aches
• Acne.

Causes:

The major cause of hormone headaches is a drop in estrogen levels. Oestrogen affects some headache-related chemicals in the brain along with the regulation of the menstrual cycle. With the fluctuating levels of estrogen, the normal working of these chemicals gets affected causing Headache.

Treatment:

• Over the counter analgesics.
• Over-the-counter Anti-Inflammatory drugs.
• Vitamin therapy: vitamins like coenzyme q10 and B2 are known to have reduced the severity of pain associated with migraine attacks.
• Triptans for Migraines.

26. Headache due to Smoking

Headache due to Smoking is very commonly seen as the smoke is a very important precipitating factor for headaches most commonly migraines.

Symptoms:

• Headache triggered by smoke
• Nausea and vomiting in people with odor sensitivity.

Causes:

Inhalation of smoke leads to an increase in carbon monoxide levels in the Blood that triggers Headache. Other than that Nicotine, being vasoactive has a vasoconstrictive effect. Vasoconstriction in the brain decreases brain activity and triggers headaches.

Treatment:

• OTC analgesics can give relief.
• A small amount of nicotine can be taken to provide relief, In case of a withdrawal headache.

27. Hypertension Headache

Hypertension Headache typically causes pain on both sides of the head and back of the head when the Blood pressure is raised.

Symptoms:

• The feeling of pressure at the back of Head and shoulders
• Nasal bleeding
• Subconjunctival hemorrhages
• Facial flushing
• Blurred vision.

Causes:

High Blood pressure leads to leakiness of blood vessels in the brain disrupting the blood-brain barrier leading to a headache.

Treatment:

• Beta-blockers: Propanolol ,salbutamol
• Calcium channel blockers: nifedipine, Amlodipine
• Potassium channel blockers: Amiodarone
• Antidiuretics: ADH, Chlorpromazine.

28. Hypnic Headache

Hypnic Headache wakes up people during sleep due to intense pain. It is also known as “Alarm clock Headache”.

Symptoms:

• Photophobia and Phonophobia
• Nausea
• Throbbing Headache.

Causes:

Headache is related to stages of sleep and sleep-related disorders such as Sleep Apnea, Night seizures, etc. Other disorders that may be associated with Hypnic Headache are Arteritis, Head traumas, and other problems.

Treatment:

• Aspirin: As an over the counter analgesic.
• Phenobarbital: Seizure associated headache.
• Melatonin: For better sleep.

29. Hypotension Headache

Hypotension Headache is usually mild to severe in intensity depending upon the severity of ischemia to the brain.

Symptoms:

• Headache at the back of Head
• Lethargy
• Dizziness and Blurred vision
• Palpitations and A weak pulse
• Cold and sweats.

Causes:

As the blood pressure drops too low, the blood supply towards the brain decreases, and enough oxygen and nutrients fail to reach the brain creating a state of hypoxia. Hypoxia in the brain can lead to ischemic shock which releases inflammatory mediators that cause Headache.

Treatment:

• Indomethacin can also be taken for pain relief.
• Oral rehydration serum is given to combat dehydration.

30. Ice-pick Headache

Ice Pick Headache can be primary or secondary and is characterized by a sharp, intense pain that lasts for a brief duration.

Symptoms:

• Stabs with spokes of ice like feeling
• A stabbing, throbbing headache
• Duration of only 5 to10 seconds
• Pricking occurs several times during the day
• Pain in the back of head, on top of head, on forehead and temples
• Facial flushing.

Causes:

The cause is unknown but this is considered to be associated with the disruption in the control mechanisms of the brain, for a short time duration.

Treatment:

You don’t really need any sort of treatment, due to a short duration of pain. However, chronic migraines and cluster headache sufferers, who also suffer from frequent icepick attacks require prophylactics.

31. Medication overuse Headache

Excessive use of medications by a headache-prone patient can give rise to a chronic headache condition known as Medication Overuse Headache.

Symptoms:

• 15 or more headaches per month which only relieve upon taking a pain-killer
• Nausea
• Dementia
• Irritability and restlessness.

Causes:

A patient with an undiagnosed case of a Headache condition such as Migraine takes an analgesics to get relief from the pain. However, the underlying condition remains unsolved and the headache returns as the effect of analgesic wear off, forcing the patient to take more analgesics and the cycle repeats itself every day. This excessive use of over the counter analgesics creates a persistent daily headache disorder.

Treatment:

• Detoxification of culprit medication should be done.
• Gradually taper off the culprit medication.
• Use alternate medicine for pain relief.

32. Migraine

Migraine is a common illness experienced by a number of people worldwide each episode lasting from 4 hours to 3 days, which can be accompanied by several symptoms.

Symptoms:

• Pressure in the head behind the eyes
• Sensitivity to light, noise, and smell
• Migraine and vomiting are closely related which usually begins with nausea
• Loss of appetite and fatigue
• Dizziness, blurred vision, and ringing sensation in ears in migraines with aura.

Causes:

A migraine begins when overreactive nerve cells send out signals to the trigeminal nerve-a nerve that supply sensation to our head and face, activation of this nerve cause release of certain chemicals that cause blood vessels in the scalp of our brain to swell up, a process called vasodilation.

Treatment:

• Acetaminophen, Aspirin, and Caffeine for pain relief.
• Metoclopramide as an anti-emetic.

33. New Daily Persistent Headache

New Daily Persistent Headache is a primary headache syndrome that involves the abrupt onset of severe, unremitting Headache with no prior history of such Headaches.

Symptoms:

• Tightening/pressing pain
• Constant pain with no pain-free episode
• Characteristic symptoms of a migraine
• Most patients with NDPH can pinpoint the exact date of the onset
• Can be an undiagnosed case of Chronic Daily Headaches.

Causes:

The hypermobility at the cervical spine joint causes convergence of Cervical and Trigeminal afferents in the Trigeminal nucleus and can lead to the development of NDPH. Alteration in levels and volume of Cerebrospinal Fluid causes headaches.

Treatment:

There are two types of NDPH:

• Self-limiting: This doesn’t need any sort of medicine and goes away itself within a year or two of onset.
• Refractory: This does not respond to any sort of treatment and might prolong for many years.

34. Occipital Neuralgia

Occipital Neuralgia is a condition that involves electric-shock like throbbing and shooting headaches that cause pain in the back of the head and neck. The pain can sometimes radiate as far as the forehead and behind the eyes.

Symptoms:

• Pain is intense, zapping, and piercing in character and is mostly felt on the affected side
• Tenderness at the scalp
• Photophobia
• Pain behind the eyes and in half of the head
• Nausea.

Causes:

Inflammation of the Occipital Nerve is the main cause and can be caused by any of these:

• A pinched nerve due to arthritis in the upper cervical vertebrae.
• Trauma or injury (like a whiplash injury) to the neck.
• A bad posture that tightens the muscles at the back of the neck and shoulders.
• A disc hernia, Inflammation from Arteritis.
• A viral Infection like Herpes Simplex.
• Other factors include Diabetes and Gout.

Treatment:

There are two approaches to help with the pain due to Occipital Neuralgia; surgical and nonsurgical, which include medications and nerve decompression.

35. Orthostatic Headache

Orthostatic Headache changes in intensity upon changing the position. The first suspect of an Orthostatic Headache is usually a CSF leak that occurs after a Spinal tap or lumbar puncture.

Symptoms:

• Dizziness
• Nausea
• Confusion
• Blurred vision
• Phonophobia
• Tinnitus.

Causes:

Orthostatic Headache is mainly due to low pressure exerted on the brain by Cerebrospinal fluid. This can be due to many reasons such as CSF leak, Hypotension Headache, Spontaneous Intracranial Hypotension (SIH), Spinal Headache, and others. As the CSF volume decreases, brain buoyancy decreases, and the brain along with other skull contents shifts downwards stretching the Dura along with it, causing a headache.

Treatment:

IV fluids: for low blood pressure and Hypovolemia.
Anti-Emetics: Metoclopramide for nausea.
Epidural Blood Patch: to seal the CSF leak.

36. Paroxysmal Hemicrania

Paroxysmal Hemicrania is a rare headache disorder that belongs to the TACs (Trigeminal Autonomic Neuralgia) group of disorders and includes sudden onset of debilitating headache on one side of the head that is short in duration but re-occurs, in some cases, several times a day.

Symptoms:

• Photophobia and Phonophobia
• Facial flushing
• Nausea and Vomiting
• Unilateral pain in the head
• Headache is throbbing in character
• Neurological symptoms on the opposite side of the body.

Causes:

Here is a list of possible causes:

• Traumatic injury to your neck or head
• Arteriovenous malformation
• Pituitary gland tumor.

Treatment:

Paroxysmal Hemicrania responds very well to indomethacin, an NSAID.
Identify your triggers and try to avoid them.

37. Post-Traumatic Headache

People who experience any sort of traumatic injury to their head or neck, very often come up with the complaint of a Headache, known as Post-traumatic Headache. This can occur due to mild, moderate, or severe trauma to the brain or even nerves from the spinal cord.

Symptoms:

• Throbbing Headache like migraines
• Dizziness
• Insomnia
• Concentration Problems
• Dementia.

Causes:

People who undergo a Traumatic Brain Injury develop a Headache very often. This can be due to several causes:

• Concussion
• Brain Hemorrhage
• Imbalance of chemicals
• Swelling or Shrinkage of brain structures.

Treatment:

• Anti-Inflammatories: Aspirin, Acetaminophen.
• Anti-Hypertensives: B-blockers, Calcium channel blockers.
• Anti-Depressants: SSRIs.
• Anti-psychotics: Clozapine, Risperidone.

38. Sinus Headache

Sinus Headache is felt in the forehead and face when the inflammation in the sinuses (hollow air spaces in the bones of the face and skull) results in the buildup of inflammatory products and exert pressure known as sinus headache pressure.

Symptoms:

• Constant feeling of pain and pressure in cheeks, forehead, around the eyes, and nasal bridge
• Running nose
• Swelling in your face
• Fever
• Decreased sense of smell
• Fatigue.

Causes:

In some cases, these sinuses become so inflamed that they block the drainage ducts resulting in failure of the inflammatory products to drain and cause pain in the forehead known as a sinus headache. Inflammation can be caused by a bacterial, viral infection or an allergic condition along with several other predisposing causes and is known as sinusitis.

Treatment:

• Antihistamines: Help treat allergic conditions.
• Decongestants: oral decongestants shouldn’t be taken for more than 7 days and one should discontinue using a decongestant spray after 3 days of use.

39. Spinal Headache

Spinal Headache occurs as a complication in people who undergo spinal anesthesia, epidural block, or lumbar puncture, thus are also known as Spinal Tap Headaches. This is common in around 50% of the people who undergo the procedure.

Symptoms:

• A dull, throbbing headache
• Dizziness and nausea
• Blurred or double vision (diplopia)
• Neck stiffness
• Worsens upon standing up or sitting down whereas the patient may feel relief on lying down.

Causes:

A spinal tap involves withdrawing a small amount of cerebrospinal fluid from the spinal cord. However, during spinal anesthesia, anesthetic medication is injected into your spinal cord. In both cases, a puncture hole is created which allows a small amount of spinal fluid to leak through it. This causes changes in pressure and thus a Spinal Headache.

Treatment:

• Hydration: In order to raise the pressure exerted by cerebrospinal fluid (CSF).
• Caffeine: Your physician might suggest taking a strong coffee or any other drink high in caffeine.
• Complete bed rest: Bed rest for 24 to 48 hours is mandatory.
• Analgesics: Sometimes Analgesics are also prescribed to relieve the pain.
• Epidural blood patch for Spinal Headache: If your symptoms do not resolve in 48 hours, your physician might suggest getting an epidural blood patch.

40. SUNCT Syndrome

Short-lasting Unilateral Neuralgiform Headache attacks with Conjunctival injection and Tearing (SUNCT) is a primary headache syndrome. It is a part of Trigeminal Autonomic Cephalgias along with Cluster Headache and Paroxysmal Hemicranias.

Symptoms:

• The headache attacks occur in three forms; single stabs, a group of stabs, and a long duration stab with no pain-free episode in between.
• In single and grouped stabs, there are pain-free episodes where the pain touches the base-line and then spikes up with stabbing.
• The frequency of attacks ranges from 2 to around 600 attacks in a day with each attack lasting for about a few seconds to a few minutes.
• Unilateral Headache.
• Ipsilateral Autonomic Symptoms in areas supplied by the division of the Trigeminal nerve.
• Loss of sensations on the Ipsilateral side.
• Conjunctival Tearing.

Causes:

There are several times that SUNCT is idiopathic and is included in Trigeminal Autonomic Cephalgias. Some case studies revealed that it was due to:

• Intracranial lesions compressing the nerve roots
• Pituitary Adenomas
• Lesions in Posterior Cranial Fossa
• Cerebellopontine Arteriovenous Malformation.

Treatment:

There is no definitive treatment for SUNCT Syndrome but the following are some options:

• For an acute attack, Intravenous Lidocaine.
• Botulinum Toxin around the symptomatic areas.
• Nerve block using thermocoagulation, gamma knife neurosurgery, alcohol, or microvascular decompression at Gasserian ganglion or first division of Trigeminal nerve.
• Hypothalamic stimulation.

41. Tension Headache

Tension Headache generally causes pain or a sense of pressure around the head that radiates forwards from the back of the head to the forehead and in temples.

Symptoms:

• Pain behind the eyes
• Headache in the temples
• Tenderness over the skull vault
• Pain at the occiput
• Mood and sleep disturbances.

• Stress
• Anxiety
• Depression.

Treatment:

Over-the-counter painkillers, Ibuprofen, Acetaminophen, and Aspirin can relieve the pain.

42. Thunderclap Headache

A Thunderclap Headache is stated as “the worst headache” ever experienced by individuals. As the name suggests, the headache strikes like thunder, without any warning, is sudden in onset but severe in intensity.

Symptoms:

Since the onset of headache is sudden and time duration is short, there are no specific associated symptoms.

Causes:

There are several possible causes of thunderclap headache and their consequences are grave:

• Decreased blood flow to the brain
• Hemorrhagic stroke
• Ischemic stroke
• Thunderclap headache after trauma
• Reversible Cerebelllar Vasoconstriction Syndrome (RCVS)
• Rapid and drastic changes in blood pressure
• Spinal leak as a result of a spinal tap or an injury
• Inflammation of blood vessels (arteritis)
• Pre-eclampsia of pregnancy
• Arterial dissection in small arteries of the brain
• An infection that has spread to the brain.

Treatment:

This is treated according to the cause. In case of an emergency, your doctor might give you an NSAID to reduce the swelling (inflammation) before carrying on with the rest of the treatment.

43. TMJ Headache

TMJ Headache is a complication of temporomandibular joint disorder. Every 1 in 10 people with temporomandibular joint disorder report with a Headache.

Symptoms:

• Lockjaw symptoms
• Cheek pain
• Stiffness and soreness of jaw muscles
• Difficulty in opening and closing mouth.

Causes:

• Constant grinding of teeth may lead to a headache.
• The facial muscles or jaw muscles may cause a headache as they become tired out of supporting and stabilizing the jaw in its abnormal position.

Treatment:

TMJ Headache is relieved permanently by treating the underlying condition.

44. Trigeminal Autonomic Cephalgias

Trigeminal Autonomic Cephalgias are short-duration primary headaches that occur unilaterally with the ipsilateral involvement of prominent cranial autonomic symptoms. These are quite painful and have characteristic recurrent attacks that make them debilitating.

Symptoms:

• Conjunctival injection and lacrimation
• Ipsilateral nasal congestion
• Rhinorrhea
• Facial flushing and sweating
• Neurological symptoms on the opposite side of the body
• Pain is triggered by movement
• Paroxysmal Hemicranias are responsive to indomethacin.

Treatment:

Treatment solely depends upon the headache type experienced by the patient.

45. Trigeminal Neuralgia

Trigeminal Neuralgia is a severe, shooting pain felt in one half of the face for a short duration of a few seconds to 2 minutes, caused by irritation of the trigeminal nerve. People who suffer from Trigeminal Neuralgia experience these attacks regularly for days, weeks, and in some cases months or years.

Symptoms:

• Excruciating pain along with constant itching and tingling
• Pain with one specific focus
• With the passage of time, the frequency of attacks increases.

Causes:

Trigeminal Neuralgia is typically caused by irritation and compression of the Trigeminal nerve most commonly due to malformed blood vessels, exerting pressure on the nerve.

Treatment:

• Anticonvulsants: topiramate, phenytoin.
• Tricyclic antidepressants: amitriptyline.
• Rhizotomy: a surgical procedure that involves damaging nerve fibers to block the pain sensations.
• Neurectomy: Involves cutting a part of the nerve.

46. Vestibular Migraine

An episode of Vestibular Migraine can consist of Vestibular symptoms alone, such as Vertigo, Nausea, and Vomiting, without any headache.

Symptoms:

The major symptom of Vestibular Migraine is a spontaneous episode of Vertigo. Other associated symptoms are:

• Motion sickness associated with the movement of the head
• Dizziness by looking at moving objects
• Nausea and vomiting are caused by constant dizziness
• A throbbing Headache on one side of the head
• Photophobia and Phonophobia
• Visual auras.

Causes:

Release of excess Neurotransmitters can be one cause. Some studies associate Vestibular Migraine with misfired nerve signals between neurons in the brain during a migraine attack.

Treatment:

• An over-the-counter analgesic for pain relief if the headache is present.
• Vestibular suppressant.
• Tricyclic antidepressants.

When to consult the doctor?

Most of the time a headache is nothing to worry about, but following are some of the conditions when you should be alarmed and book an appointment with your doctor as soon as possible:

• If you have been experiencing more than 3 episodes of headache within a short time span of 15 days.
• If your headache is accompanied by serious symptoms such as loss of vision, vomiting, fever, numbness, a loss of sensations, or dizziness.
• If you need a higher dose of medication, to treat the headache than you needed a few days ago.

FAQ