Headache: Types And Causes

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Headache: Types And Causes
Headache: Types And Causes
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Video: Headache - Overview (types, signs and symptoms, treatment) 2023, February
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Headache: forms & causes

Primary headache disorders are diseases in their own right. Secondary headache is caused by a different condition. The most common types of headache include tension headaches, cluster headaches, and migraines.

Headaches due to underlying diseases can have various causes, such as the flu or tension.

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  • What causes a headache?
  • Independent headache disorders: migraines & Co.
  • Headache from overuse of pain relievers and migraine drugs
  • Headache caused by underlying diseases

What causes a headache?

How primary headaches (independent headache disorders) develop has not yet been clearly researched. It is possible that genetic predispositions play a role. In addition, there can be so-called triggering factors for headache attacks, e.g. stress, hunger or lack of sleep. In cluster headaches, it is known that alcohol can promote attacks.

Headaches due to underlying illnesses (secondary headaches) can have various causes, such as the flu, sinus infections or tension. The causes of headaches are rarely found in very serious diseases such as brain tumors, cerebral haemorrhages or meningitis as well as glaucoma or severe high blood pressure. Medicines can also cause headaches. For example blood pressure medication, hormone preparations or means to increase potency. Frequently taken pain relievers for headaches can favor the so-called "drug-induced headache".

Independent headache disorders: migraines & Co

The independent (primary) headache disorders include:

  • Migraine,
  • Tension-type headache (so-called "tension headache"),
  • trigeminal autonomic headache (e.g. cluster headache),
  • other primary headaches (e.g., new daily headache or sex-associated headache, headache when exposed to cold or while sleeping).

Migraine attacks

Migraine is a brain disease that is likely to be caused by a genetic predisposition. Headache attacks and possible side effects such as nausea or sensitivity to light occur. The triggers are not exactly known. "Triggers" can trigger migraine attacks. These are individually different, e.g. stress. Especially during menstruation, women are prone to prolonged attacks of greater intensity and nausea. Women of childbearing age are about three times more likely to experience migraines than men. For full details on migraines, see Migraines: What is it? as well as migraines: diagnosis & therapy.

Tension headache

Almost everyone is confronted with it in the course of life. It comes to pressing, dull or pulling headaches, which usually occur on both sides. Women and men suffer from tension-type headaches ("tension headaches") about equally often. These usually feel like a helmet or headband is sitting too tightly on your head. The pain is mild to moderate and can last from half an hour to a few days. The pain is not increased by normal exercise. If at least 15 days of "tension headache" occur per month for more than three months, one speaks of chronic tension headache. There is not always tension in the head, face or neck muscles - as is widely assumed.

Trigeminal autonomic headache: cluster headache & Co

Rare forms of mostly one-sided headaches, which are characterized by relatively short attacks of pain and accompanying symptoms (tearing, reddening of the skin, swelling of the eyelids, etc.) are summarized under the term trigemino-autonomous headache.

  • Cluster headache: Cluster headaches are probably the most severe headaches there is. There are single, unilateral attacks with piercing, stabbing pain in the eye area that last 15–180 minutes if left untreated. The seizures can last up to three hours and occur several times a day, with a maximum during the night. In addition, there may be redness, constriction of the pupil and drooping of the affected eyelid on the same side as the headache. This may also be accompanied by reddening of the face on one side. Those affected have an urge to move (pacing around) during the attack. A distinction is made between episodic (seizure-free intervals) and chronic cluster headaches (no longer symptom-free interval). If the seizures occur almost continuously one after the other,hospital treatment is required. Men are more often affected by cluster headaches, the gender distribution is around 3: 1.
  • Paroxysmal hemicrania: Paroxysmal hemicrania is very similar to cluster headache. The attacks last much shorter, however, and occur very often during the day (about ten times). Women are significantly more often affected by paroxysmal hemicrania, the gender distribution is around 3: 1. Hemicrania can also become chronic.
  • SUNCT syndrome: The SUNCT syndrome (short-lasting uniform neuralgiform headache with conjunctival injection and tearing) is characterized by extremely short headache attacks (seconds to a few minutes) that are, however, incredibly violent. Those affected describe the pain as if they had hit a "nerve" directly. On average there are sixty or more attacks a day, and in rare cases two hundred are possible. The headache can only be felt on one side or in the eye. The affected eye is reddened and watery. The gender distribution in SUNCT syndrome is estimated to be 3: 1 or 5: 1 (women: men).

New daily headache

It is a headache that occurs within a day and is more or less constant from this point onwards. Other diseases must be ruled out especially in this diagnosis. The pain can be moderate to severe and reminiscent of migraines. It is possible that this type of headache will completely resolve within a period of two years. However, it can also continue beyond that.

Sex-associated headache

In connection with sexual activity, headaches on both sides can develop (primary headache during sexual activity). It describes pre-orgasmic headaches ("dull" pain) that can occur before the climax, as well as orgasmic headaches ("explosive" pain). The intensity of the headache increases with sexual arousal. Sometimes with a few minutes of short duration, this form of headache can last up to two days. Sex-associated headaches primarily affect men, the gender ratio is around 3: 1.

Headache from overuse of pain relievers and migraine drugs

If painkillers (including those that are freely available) are taken in an uncontrolled manner, it can develop into an independent pain syndrome. One speaks of headache when overuse of painkillers or migraine drugs (Medication Overuse Headache = MOH). In terms of symptoms, they resemble tension-type headaches or migraines. If you stop taking painkillers immediately, you may experience withdrawal symptoms. For more information on pain medication addiction, see Painkillers.

Headache caused by underlying diseases

The cause of so-called secondary headaches can be traced back to underlying diseases, e.g.

  • Sinus infection,
  • Sleep apnea,
  • Cerebral hemorrhage,
  • chronic glaucoma,
  • High blood pressure,
  • Meningitis,
  • Injuries to the head and / or cervical spine,
  • a brain tumor,
  • Cerebral hemorrhage or
  • Thrombosis of the cerebral vessels.

Diagnosis and therapy depend on the particular disease. The so-called idiopathic intracranial hypertension (“pseudotumor” of the brain), which can also lead to headaches, occurs rarely.

For more information, see Headache: Diagnosis and Therapy.

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