Public Spark

Headaches can literally interrupt your day and make you feel miserable. I’ve experienced several different types of headaches, including sinus headaches, stress related headaches, and caffeine withdrawal headaches.

What are headaches? (Wikipedia, Medicine Net, Neurology Channel)

A headache (cephalagia in medical terminology) is a condition of pain in the head. It can be chronic, recurrent, or occasional and the pain can be mild or severe enough to interrupt daily activities. Headaches often result from traction to or irritation of the meninges and blood vessels. The membrane surrounding the brain and spinal cord, called the dura mater, is innervated with nociceptors (a sensory receptor that sends signals that cause perception of pain). Stimulation of these dural nociceptors is thought to be involved in producing headaches. In the United States, over 45 million people—including more than the 33 million sufferers of asthma, diabetes, and heart disease—experience chronic, recurring headaches. Of these, 28 million suffer migraine every year.

Types of Headaches (Wikipedia, Medicine Net, Neurology Channel, National Institute of Neurological Disorders and Stroke, American Headache Society, Medline Plus)

• Vascular Headaches

  The most common vascular headache is a migraine, which are usually characterized by severe pain on one or both sides of the head, an upset stomach, and for some people disturbed vision. In the United Sates, migraine headaches often go undiagnosed or are misdiagnosed as tension or sinus headaches resulting in many migraine sufferers not receiving effective treatment. Migraines are caused by a combination of vasodilatation (enlargement of blood vessels) and the release of chemicals from nerve fibers that coil around the blood vessels. Enlargement of the temporal artery stretches the nerves that coil around the artery and causes the nerves to release chemicals, which in turn cause inflammation, pain, and further enlargement of the artery.

  ICHD-II Classification Criteria for Migraine

  A. At least 5 attacks fulfilling criteria B-D below

  B. Headache attacks lasting 4-72 hours

  C. Headache has at least two of the following characteristics:

  1. unilateral location

  2. pulsating quality

  3. moderate or severe pain intensity

  4. aggravation by or causing avoidance of routine physical activity (ex. walking or climbing stairs)

  D. During headache at least one of the following

  1. nausea and/or vomiting

  2. photophobia and phonophobia

  E. Not attributed to another disorder

• Cluster Headaches

  Cluster headaches are a rare type primary headache, affecting 1 % of the population. An estimated 85% of cluster headache sufferers are men between the ages of 20 and 40. Some triggers associated with cluster headaches include drugs that dilate or constrict blood vessels and alcohol.

  ICHD-II Classification Criteria for Cluster Headache

  A. At least 5 attacks fulfilling criteria B-D

  B. Severe or very severe unilateral orbital, supraorbital and/or temporal pain lasting 15-180 minutes if untreated

  C. Headache is accompanied by at least one of the following

  1. Ipsilateral conjunctival injection and/or lacrimation

  2. Ipsilateral nasal congestion and/or rhinorrhea

  3. Ipsilateral eyelid edema

  4. Ipsilateral forehead and facial sweating

  5. Ipsilateral miosis and/or ptosis

  6. A sense of restlessness or agitation

  D. Attacks have a frequency from one every other day to 8 per day

  E. Not attributed to another disorder

• Myogenic (muscle tension)

  These involve tightening or tensing of facial neck muscles; they may radiate the forehead. Tension headache is the most common form of myogenic headache with as many as 90% of adults have had or will have tension headaches. They are more common among women than men. It is described as a band of pressure encircling the head with the most intense pain over the eyebrows. The pain of tension headaches usually is mild (not disabling) and bilateral (affecting both sides of the head). They are caused by stress, muscular tension, vascular dilation, postural changes, protracted coughing or sneezing, and fever.

  ICHD-II Criteria for Tension-Type Headache

  A. At least 10 episodes occurring on <1 day per month on average (<12 days per year) and fulfilling criteria B-D below

  B. Headaches lasting from 30 minutes to 7 days

  C. Headache has at least two of the following characteristics

  1. bilateral location

  2. pressing/tightening (nonpulsatile) quality

  3. mild or moderate intensity

  4. not aggravated by routine physical activity such as walking or climbing stairs

  D. Both of the following:

  1. no nausea or vomiting (anorexia may occur)

  2. no more than one of photophobia or phonophobia

  E. Not attributed to another disorder

• Cervicogenic

  They originate from disorders of the neck, including the anatomical structures innervated by the cervical roots C1-C3. It is often precipitated by neck movement and/or sustained awkward head positioning.

• Traction and Inflammatory

  These are a result of symptoms from other disorders like tension headache, idiopathic intracranial hypertension, cluster headache, brain freeze, vascular headache, hangover, sinusitis, etc

General Resources:

• National Headache Foundation

• Family Doctor

• Web MD

• Mayo Clinic