Headache

 A person with a headache has discomfort or pain beneath the scalp or forehead, behind the eyes, or arising from the head or upper neck. While headaches may occur occasionally or frequently, they are still the most common nervous system disorder in the world. Evidence suggests that 52 percent of the global population is affected by a headache disorder every year, with 14 percent reporting migraine.

There are more than 150 types of primary and secondary headache disorders, according to the National Institute of Neurological Disorders and Stroke. Headaches can be the body’s reaction to emotional stress, grief, too much or too little sleep, or depression. Some people get a headache after physical exertion, crying, eye strain, or sex. Sometimes headaches are harmless and come and go in a matter of minutes, while other types of headache can be a symptom of a serious health problem.

Types of Headaches

Headaches may be primary or secondary, says Emad Estemalik, MD, a neurologist and the section head for headache and facial pain at the Center for Neurological Restoration at the Cleveland Clinic in Ohio.

“A primary headache is a headache that occurs independently and is not caused by another medical condition,” says Dr. Estemalik. “Secondary headache is when the head pain is being caused by another health issue; for example, a brain tumor would be a secondary cause of headache.” Secondary headaches are more concerning than primary headaches because they could be a sign of a more serious underlying health condition, he adds.

Migraine, cluster, and tension-type headaches are the most common types of primary headache. Secondary headaches can be caused by tumors, head injury or trauma, high blood pressure, fever, infection, or medication overuse.Many people use the words "migraine" and "headache" interchangeably, but a migraine attack is more than just a bad headache. Migraine is a neurological disorder that typically causes severe headaches but can also cause visual disturbances, nausea, vomiting, and extreme sensitivity to light, sound, touch, and smell along with head pain.

Migraine is very common; next to tension-type headache, it’s the most common type of headache. According to JAMA Network, in the United States over 17 percent of women and nearly 6 percent of men report having migraine symptoms.

It’s estimated that about 25 to 30 percent of people with migraine experience aura, which is described as a series of visual, sensory, or speech changes that occur shortly before the head pain hits. The American Migraine Foundation describes visual aura symptoms as including seeing lines or spots, sensory symptoms may include tingling or numbness in one or more areas of the body, and speech symptoms may include slowing and slurring of speech or difficulty understanding what others are saying.

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Migraine pain is often described as throbbing and piercing. It generally occurs on one side of the head and lasts anywhere from 4 to 72 hours. Symptoms can include sensitivity to light and loud noises, nausea, and vomiting.

Learn More About Migraine

Tension-Type Headache (Also Called Stress Headache)

Tension-type headaches are the most common type of headache, and they tend to be milder than migraine attacks, says Katherine Hamilton, MD, of Medstar Health in Washington, DC.

“Tension-type headaches have different characteristics than migraines in that they tend to affect both sides of the head and involve a dull, pressure-type pain,” Dr. Hamilton says. Many people describe tension headaches as having a band squeezed around their head.

Tension-type headache can have a muscular component to the headache: The head and neck muscles can get a little bit tenser, says Estemalik. “Skull, head, and neck tenderness can happen in this type of headache,” he adds.

Cluster Headache and Other Trigeminal Autonomic Cephalalgias

Cluster headaches are relatively rare, affecting between 200,000 and 1 million Americans, according to the American Migraine Foundation. These headaches come in clusters (also known as cycles or periods) that can happen about once or twice a year and might last as long as a month, or even longer, per the University of Michigan Health. While technically not life threatening, these headaches cause such severe pain that some people contemplate suicide.

Cluster headache comes on suddenly, is almost always one-sided, and is associated with a piercing and very intense pain, says Kiran Rajneesh, MD, a pain medicine doctor and headache specialist at The Ohio State University Wexner Medical Center in Columbus.

The headaches generally last 15 minutes to 3 hours, often waking the person from sleep, with pain localized behind one eye or at the temple near the forehead; a runny nose and tearing on the side with the pain is also common.

Whereas people with migraine often retreat to a dark room to lie down, people with cluster headaches pace and can sometimes exhibit aggressive behavior, says Dr. Rajneesh. “Because the pain of a cluster headache is so severe, patients can become very agitated and restless,” he says.

The underlying cause of cluster headache is not known. Per the Mayo Clinic, cluster headache patterns indicate that they may be connected to abnormalities in the body’s biological clock, located in the hypothalamus, the area of the brain that produces hormones that control body temperature, heart rate, and appetite.