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Neurology online by Dr. Strizhak

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Brooklyn, NY 11235
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Headaches

Headache Types Overview

Headache Types Overview

Besides carrying precious cargo, which is the brain, and serving one of the most essential pleasures, which is eating, the head also tends to annoy our senses pretty often. No other part of the body hurts so much for no apparent reason.

All headache syndromes are divided into two broad categories, which are primary and secondary headaches.

Primary headaches are headache types that are not caused by any other disease. They often tend to run in families. Primary headaches come and go as they are pleased and they all have benign prognosis, which translates into lack of any health consequences. On the other hand, most of primary headaches are often moderate-to-severe in intensity and may literally ruin the quality of life. The most common type of primary headache is a well-known migraine.

Secondary headaches are caused by some other disease. Severity, consequences, and prognosis of these headaches depend on the underlying cause. As an example, temporal arteritis very often causes a constant and annoying headache, which is typically limited to one side of the head. This pain, however, is the least of a problem. Missed diagnosis and lack of appropriate treatment may lead to permanent loss of vision in one or even both eyes.

Tension type of headache is somewhat different from the rest of headache syndromes. It is officially classified as a primary headache. The rational for this classification is lack of any underlying brain or head disease. On the other hand, it is commonly occurring secondary to some life style “sins” or it is caused by stress and conditions affecting quality of life, such as depression or sleep apnea.

Headaches to be concerned about

New type of headache is always a diagnostic challenge because most of headache syndromes are diagnosed on the basis of headache pattern, which requires time for observation. Even first attack of migraine or cluster headache – no matter how classical it is – has to be taken seriously and often requires diagnostic work up.

The most concerning headache in acute setting is a sudden onset of severe headache. It is often called “worst of life headache”. This headache reaches its maximum within a minute and stays for quite some time. Even if there are no other symptoms like confusion, weakness, vomiting, etc., it is a subarachnoid hemorrhage, until proven otherwise. Brain aneurysm has to be ruled out in this case. Similar headaches can be caused by pituitary apoplexy and vessel dissections. There is a benign counterpart to sudden severe headache. It is called primary thunderclap headache. It is usually impossible to differentiate them without diagnostic testing.

Another concerning type of headaches is chronic daily headache. It always requires thorough neurological evaluation and diagnostic testing. Even though, it most commonly caused by chronic sleep deprivation, sleep apnea, or depression, similar pattern of headache may be a sign of pseudotumor cerebri in young ladies or temporal arteritis in people over age of 60.

Any headaches that are associated with weakness, numbness, problems with vision, or loss of any other body function have to be evaluated by neurologist.

 

Headache Management

Headache treatment depends exclusively on the cause. In case of secondary headache, treatment approach is dictated by the underlying cause. Primary headache treatment is always syndrome specific. Regular pain medications don’t work for those pains, except migraine.

Headaches are extremely common even in otherwise healthy people, but headache specialists are in short supply. This discrepancy often leads the to headache mismanagement even when the diagnoses are made correctly. Some headache types are diagnosed after years of suffering and visits to multiple doctors. On average, cluster headache is diagnosed on the seventh year, after visiting four doctors, and after having four incorrect diagnoses. Other headaches such as nummular headache and hemicrania continua are almost never diagnosed correctly. SUNA syndrome appears to be much more common than statistics says and those people are inappropriately treated for trigeminal neuralgia for years.

Majority of headache syndromes are manageable as long as the diagnosis is correct and the treatment chosen matches the headache syndrome. People suffering frequent headaches often adjust their habits accordingly. However, many headache sufferers are unaware that they may have much more normal life style with the right headache management.

Any comments about this page will be greatly appreciated at doctorstrizhak@gmail.com Content copyright 2017. DOCTORSTRIZHAK.COM. All rights reserved.
Disclosure: This Web Site is intended for education purpose only. The information provided on this site must not be perceived as a guide for self-diagnosis or self-treatment. Every effort is made to keep the information current, but there are absolutely no guarantees of timely updates. By Andre Strizhak