Classification of headaches

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Headaches are an important public health issue that impact the lives of a significant of the world’s population, affecting patients with severe pain, nausea and sometimes visual impairment. Headaches can be caused by several pathological conditions. Figuring out what leads to the pain may require you to observe the environment, eating habits, daily routine, activities that spark headache discomfort.

About 95% of headaches are caused by such common conditions such as stress, fatigue, lack of sleep, hunger, dehydration, changes in estrogen level, or caffeine intake. Headache can be the initial symptom of a life-threatening condition such as bleeding, infection, or a tumor.

A headache can also be the only warning signal of high blood pressure (hypertension). In addition, certain medications — such as nitroglycerin, prescribed for a heart condition, and estrogen, prescribed for menopausal symptoms — are notorious causes of headache.

Questions asked by the doctor

There are multiple causes to this symptom. While recording the patient’s history, the physician must take care to thoroughly investigate the following:

  • How long the patient has been suffering from headaches?
    (Is this pain always felt with the same intensity, or does it become more severe with time?)
  • What type of pain does the patient feel?
    (Is it constant, or intermittent? If intermittent, how long do the headache episode last? When do the headache episode occur, at what time during the day? Under what circumstances?)
  • Is the headache accompanied by other symptoms?
    (Other symptoms may include blurred vision, vertigo, tinnitus, nausea, vomit, stroke signs)

The patient suffering from a headache requires a complete examination of all organs, starting from a fundus oculi examination (an exam to visualize the innervation of the base of the eye), an examination of the nose and sinuses, arterial pressure, examinations of the liver and kidneys, a head CT scan, MRI, X-ray.

Common headache types include tension headaches, cluster headaches, rebound headaches, sinus headache, and migraine.

When to seek care

Seek immediate medical care if your headache:

  • Is sudden and severe
  • Accompanies a fever, stiff neck, rash, confusion, seizure, double vision, weakness, numbness or difficulty speaking
  • Follows a head injury
  • Gets worse despite rest and pain medication
  • Is a new type in someone older than 50
  • Wakes you from sleep


Headaches Classification

Headaches are classified into three groups:

  1. Primary and Secondary Headaches
  2. Cranial Neuralgia
  3. Facial Pain (primary or central)

Primary Headaches

Primary Headaches include:

  • Migraines
  • Tension headaches
  • Cluster headaches, and other trigeminal autonomous headaches
  • Other primary headaches


Secondary Headaches

These headaches occur with a specific cause. These are headaches which are connected to another condition, the latter supposedly responsible for the headache.

Secondary headaches include:

  • Headaches due to neck or head injury
  • Headaches due to vascular conditions of the neck or head
  • Headaches due to intracranial non-vascular conditions
  • Headaches due to substance addiction or due to abrupt cessation in their consumption
  • Headaches due to infections
  • Headaches due to disruptions of homeostasis (a stable equilibrium of certain variables within the body, like for example maintaining a stable body temperature, blood pH, concentration of sodium, potassium, etc.)
  • Headaches or facial pains due to cranial, neck, eye, nose, sinus, teeth, mouth or other cranial or facial conditions
  • Headaches due to psychiatric conditions
     

Medically Reviewed by a doctor on 12 Oct 2017
Medical Author: Dr. med. Diana Hysi