Headaches are typically classified by the cause:
Primary headache is defined as headache caused by increased electrical activity or an issue with pain structures in the head. A primary headache is not a sign of an underlying disease.
Migraine is a common type of primary headache. The condition may also be associated with nausea, vomiting, dizziness, visual disturbances, and/or tingling in the face, feet, or hands. It may be accompanied with sensitivity to light and sound. Migraines tend to be inherited. Common triggers for migraines include stress, lack of sleep, over consumption of caffeine, hunger, and dehydration. Treatment options for migraine includes medication to prevent migraines. There are 5 classes of medications to prevent migraine i.e. beta blockers, anti epileptics, antidepressants, CGRP blockers, and Botox injections.
Migraines may be classified as:
- Chronic migraine-is a condition characterized by 15 or more headache days a month.
- Episodic migraine- is a condition characterized by 0-14 headache days a month
- Complex migraine(migraine with aura)- a condition characterized by migraine with reversible neurological symptoms. A complex migraine may be associated with visual disturbances, tingling, numbness, and difficulty speaking.
Cluster headache- is another common type of primary headache. It is a condition in which frequent attacks of headache come and go. The headache attacks are typically followed by a remission period, in which the headaches stop. Symptoms of cluster headache may include runny nose, drooping eyelid, pain behind the eye, redness of the eye, and excessive tearing. Patients with cluster headache may also have light sensitivity and sensitivity to sound.
The cause of cluster headaches is unknown, but is likely caused by an abnormality of the hypothalamus. Cluster headache is more likely to occur in men, people between the ages of 20-50, smokers, and people who drink alcohol.
Tension Headaches are another common type of primary headache. It is commonly described as a mild to moderate headache that feels like a tight band is around the head. Tension headaches may also be classified as chronic or episodic. Unlike with migraine, tension headache is not worsened with activity.
A secondary headache is caused by an underlying medical condition:
Temporal arteritis(Giant cell arteritis)- Temporal arteritis is an autoimmune disease that causes inflammation that damages medium and large sized arteries. The inflammation causes swelling and narrowing of the arteries, which decreases blood supply. The condition most often affects the arteries that supply blood to the head. This condition may lead to headache, scalp tenderness, facial pain, and vision changes.
Temporal arteritis is more common in female patients. Other risk factors for temporal arteritis are being over the age of 50 and having European descent, especially Scandanavian descent. Patients with a history of polymyalgia rheumatica also have an increased risk of developing temporal arteritis.
Temporal arteritis is diagnosed based on history and examination. The condition is confirmed with a biopsy of the temporal artery. Temporal arteritis is typically treated with steroids to reduce inflammation and avoid complications such as vision loss.
Cervicogenic headache- a condition in which pain is referred from the neck to the head. The headache may be associated with neck pain or stiffness, decreased range of motion in the neck, and pain radiating to the shoulder or arm. Cervicogenic headache may be triggered by turning the head, pressing on the back of the neck, or poor posture. Treatment for cervicogenic headache depends on the underlying cause and may include physical therapy, medication, cervical ESI, cervical radiofrequency ablation, or surgical treatment.
Sleep apnea- Sleep apnea is a sleep disorder in which breathing stops and starts repeatedly. It is a condition that causes secondary headaches. Snoring and feeling tired even after a full night of sleep are also symptoms suggestive of sleep apnea. Other symptoms of sleep apnea include difficulty staying asleep, daytime sleepiness, difficulty concentrating, and irritability.
Factors that increase the risk of sleep apnea include obesity, a narrowed airway, nasal congestion, smoking, alcohol use, and a family history of sleep apnea. Sleep apnea is also more common in men and occurs more in older adults.
A sleep study is typically used to diagnose sleep apnea. A CPAP(continuous positive air pressure) machine helps keep the airway passage open and is the most common and reliable way to treat sleep apnea.
Brain tumor- Secondary headache may also be caused by a brain tumor. A tumor occurs when normal cells become mutated. These mutations cause the cells to rapidly grow and divide. People with a family history of cancer and exposure to radiation are at an increased risk of developing a brain tumor.
An MRI of the brain is often used to diagnose brain tumors. The treatment for a brain tumor varies but may include surgery, radiation, or chemotherapy.
Anemia- Anemia is a condition in which there is lack of healthy red blood cells to carry oxygen to the tissues of the body. Symptoms of anemia include headache, dizziness, fatigue, shortness of breath, chest pain, and irregular heartbeat.
