Overview
Acute headaches can be due to serious causes like brain hemorrhage, tumours, infections and inflammations and when a headache presents acutely, it must be taken as a symptom of “something going wrong” in the brain, just like chest pain heralds a heart attack.
Of the recurrent headaches with no acute cause:
Tension Vascular Headaches are most common in young people and present as a tight band affecting the forehead and temples.
Migraine headaches usually start on one side and then generalise. They are accompanied by sensitivity to light, noise, or smells; nausea or vomiting; loss of appetite; and upset stomach or belly pain. Migraine headaches often have warnings (auras) and may present with complex symptoms like vertigo, diplopia (double vision) and paralysis.
Cluster headaches are the most intense headaches that often wake one up from sleep and appear in “clusters”- periods of intense pain followed by pain free periods. You could have intense burning or piercing pain behind or around one eye. It can be throbbing or constant. The pain can be so bad that most people with cluster headaches can’t sit still and will often pace during an attack. On the side of the pain, the eyelid droops, the eye reddens, pupil gets smaller, or the eye makes tears. The nostril on that side runs or stuffs up.
Sinus headaches a deep and constant pain in your cheekbones, forehead, or on the bridge of your nose. They happen when cavities in your head, called sinuses, get inflamed. The pain usually comes along with other sinus symptoms, like a runny nose, fullness in the ears, fever, and a swollen face.
Signs
Symptoms of migraine tend to occur in stages:
Before the headache: According to older research, around 20–60% of people experience symptoms that start hours, or possibly days, before the headache. These include physical and sensory symptoms, such as aura.
During the headache: Alongside a mild to severe throbbing or pulsing headache, symptoms may include nausea, vomiting, and nasal congestion.
Resolution: Tiredness and irritability may last another 2 days, and this period is sometimes called the “migraine hangover.”
- head pain that worsens during physical activity or straining
- an inability to perform regular activities due to pain
- increased sensitivity to light and sound that lying quietly in a darkened room relieves
Chronic Daily Headaches present 15 days or more a month for longer than 3 months. Some are short. Others last more than 4 hours. It’s usually one of the four types of primary headache:
- Chronic migraine
- Chronic tension headache
- New daily persistent headache
- Hemicrania continua
Diagnosis
- Symptoms:
- Pain
- Dizziness & Vertigo
- Nausea & Vomiting
- Visual disturbances