Headache: Definition, Types, Risk Factors, Causes, Symptoms, Diagnosis and Treatment

Headaches are common, and many people are treated with simple pain relievers.

They generally drink more fluids and rest, or just wait for the headache to go away .

Headaches are generally not serious.

However, sometimes when associated with other signs and symptoms, headaches can be an indication of a serious underlying condition.

Pain is felt when various organs of the head become inflamed or irritated. These organs include:

  • The muscles and skin of the head.
  • The nerves of the head and neck.
  • The arteries leading to the brain .
  • The membranes of the ear, nose and throat.
  • The sinuses, which are air-filled cavities inside the head that are part of the respiratory system.

Headache types

There are different types of headaches and there are many different causes, which explains why the condition is so common.

Most headaches have more than one contributing factor.

Some of the most common headache triggers are related to lifestyle, such as poor diet, stress, muscle tension, and lack of exercise.

Serious underlying disorders, such as brain tumors, are rarely the cause of the headache, although a persistent headache should always be investigated by a doctor.

Headache can be classified into two broad categories: primary and secondary.

Primary headaches

Primary headaches are those that are not the result of another medical condition.

The category includes tension, migraine and cluster headaches.

Tension headaches

It is the most common type of headache. Tension headaches tend to be mild to moderate, non-throbbing, and bilateral (on both sides of the head).

In general, they do not get worse during routine activities such as bending over, walking stairs, among others.

Because tension-type headaches tend to be mild, patients generally treat them successfully with over-the-counter medications.

Patients should be aware that using over-the-counter medications too often can lead to chronic (long-term) headaches every day.


It is the second most common type of primary headache.

The exact cause of migraines is unknown, although they are caused by changes in the nerves and blood vessels.

Migraines are also related to changes in the brain and inherited abnormalities in certain areas of the brain.

Migraine pain can be moderate to severe, and is described as throbbing or throbbing pain.

Migraines can last from four hours to three days and typically occur one to four times a month.

The symptoms of migraine are sensitivity to light, noise, and smells.

Symptoms such as nausea or vomiting with loss of appetite and abdominal pain or upset stomach may also occur.

Cluster headaches

This type of primary headache is less common, but more serious.

The pain of a cluster headache is intense and has a burning or piercing quality that pulses or is constant.

Cluster headache pain is so severe that most people cannot relax and become restless during an attack.

The pain is localized behind one eye or in the region of the eye, without changing sides.

The term “cluster headache” refers to headaches that come in a group.

Cluster headaches occur one to three times in a day and can last from 2 weeks to 3 months.

The headaches disappear completely or go into remission for several months or years and then reappear.

New daily persistent headaches

They are a form of primary headache, it is not associated with a physical illness.

A new daily nagging headache starts abruptly as a headache that is new to the patient.

The patient must be able to identify the short period of time (72 hours) when the headache appeared.

While these headaches may not be related to other illnesses, they tend to be constant or persistent, bilateral (located on both sides of the head), and do not respond to many medications.

Secondary headaches

Secondary headaches, or those that result from another medical or neurological condition, include sinus headaches, medication abuse headaches, or headaches that occur due to a head injury, trauma, or more serious condition, like a tumor.

Sinus headache

These headaches are associated with constant, deep pain in the cheekbones, forehead, or bridge of the nose.

Pain is usually worse with sudden head movement or straining and occurs with other acute sinus symptoms, such as a runny nose, an unpleasant taste in the mouth, a feeling of fullness in the ears, fever, facial swelling, and sinus pain. affected paranasal cells.

Medication overuse headaches

These headaches occur as a result of overuse of available over-the-counter pain relievers or prescription pain relievers such as opiates and sedative-hypnotic pills designed for headache treatment such as butalbital-containing headache medications.

This is the most common type of chronic headache seen in specialist headache centers and is known as a “transformed” headache.

Tension or migraine headaches that are intermittent can transform into a chronic headache due to overuse or inappropriate use of medications.

These headaches can also occur without the overuse of pain relievers.

Worldwide, 4% of the population is believed to have chronic daily headaches of some kind, and a good percentage of this population includes medication overdose headaches.

Risk factors for headache

Headaches, especially migraines, can be inherited.

Children who have migraines usually have at least one parent who also has the disease.

Headaches can also be triggered by certain environmental factors, such as:

  • Tobacco smoke
  • Strong smells of household chemicals or perfumes.
  • Exposure to certain allergens .
  • Eat certain foods.
  • Stress, pollution, noise, lighting, and weather changes are other environmental factors that can trigger headaches in some people.

People with migraines can inherit abnormalities in certain areas of the brain, as well as the tendency to be affected by certain migraine triggers, such as fatigue, bright lights, changes in weather, and others.

Causes of headache

Headache is the result of signals that interact between the brain, blood vessels, and surrounding nerves.

During a headache, specific nerves in the blood vessels are activated and send pain signals to the brain.

However, it is not clear why these signals are activated in the first place. There is a “pain center” or migraine generator in the midbrain area.

A migraine begins when overactive nerve cells send impulses to the blood vessels.

This causes the release of prostaglandins, serotonin, and other substances that cause inflammation of the blood vessels in the vicinity of the nerve endings, resulting in pain.

Headaches that start suddenly and acutely and are usually caused by illness, infection, cold, or fever.

Other conditions that can cause a severe headache include sinusitis (inflammation of the sinuses), pharyngitis (inflammation or infection of the throat), or otitis (infection or inflammation of the ear).

Headaches can be caused by a blow to the head and are rarely a sign of a more serious illness.

Common triggers for tension headaches or migraines include:

  • The emotional stress related to family and friends, work or school.
  • Alcohol consumption.
  • Skipping meals
  • Changes in sleep patterns
  • Overuse of medications.
  • Tension.
  • Depression .

Other causes of headaches include eye strain and neck or back strain caused by poor posture.

When headaches become progressive and occur along with other neurological symptoms, they can be the sign of a disease process in the brain, such as:

  • Hydrocephalus (abnormal accumulation of fluid in the brain).
  • Meningitis (an infection or inflammation of the membrane covering the brain and spinal cord).
  • Encephalitis (infection and inflammation of the brain).
  • Hemorrhage (bleeding inside the brain).
  • Tumor.
  • Blood clots along the surface of the brain.
  • Head trauma
  • Abscesses
  • Toxins (overexposure to chemicals, including certain medications).


The symptoms of a headache are more than just a headache and depend on the type of headache an individual has.

For some people, it is these “other” symptoms, such as nausea or sensitivity to light, that cause the most discomfort.

Common symptoms of primary headaches: Headaches that occur on their own and are not due to an underlying medical condition.

Symptoms of a migraine

  • Throbbing or throbbing headache, usually on one side of the head, but can be on both.
  • The pain is worse with physical activity.
  • Sickness.
  • Vomiting
  • Sensitivity to light, called photophobia.
  • Sensitivity to sound, called phonophobia.
  • Premonitory phase that begins up to 2 days before the migraine and is associated with emotional changes, yawning, urinary frequency, fluid retention, stiff neck, feeling thirsty or food cravings.
  • Symptoms such as vision changes, numbness and tingling, dizziness, confusion, and / or language problems, such as difficulty finding words.
  • Increased sense of smell.
  • Difficult to focus.
  • Emotional stress
  • Phase characterized by fatigue, irritability or euphoria.

Symptoms of a tension headache

  • Sensation of pain or pressure on both sides of the head, starting at the forehead.
  • Feeling of fullness in the head.
  • Headache lasts from 30 minutes to 7 days.
  • The headache usually starts sometime during the day, then slowly increases, and then becomes stable.
  • Radiation of pain to the neck and / or shoulders.
  • Loss of appetite
  • Sensitivity to light or sound, but not both.
  • The pain is not worse with physical activity, as in the case of migraines.

Symptoms of a cluster headache

  • Very sharp headache, usually centered around the eye, often described as piercing.
  • The headache occurs in short bursts, lasting 45 to 90 minutes.
  • Runny nose (on the same side as the headache).
  • Watery eye (on the same side as the headache).
  • Swelling of the face (on the same side as the headache).
  • Swelling of the eyelid (on the same side as the headache).
  • Facial flushing and sweating.
  • Agitation, restlessness.

Migraine symptoms that may appear: nausea, aura, sensitivity to light, sensitivity to sound.

Headache diagnosis

Once a correct headache diagnosis is made, an effective treatment plan can be started.

When you have headache symptoms, your doctor will perform a complete physical exam and headache evaluation.

During the headache evaluation, the doctor will consider the history and description of the headache.

The symptoms and characteristics of the headache will be reviewed as completely as possible.

A headache evaluation may include a CT scan or MRI if the doctor thinks there might be a problem with the central nervous system.

Both tests produce cross-sectional images of the brain that can reveal abnormal areas or problems.

X-rays of the skull are not helpful.

An EEG is also unnecessary unless you’ve ever passed out during a headache.

If headache symptoms worsen or become more frequent despite treatment, see your family doctor for a referral to a specialist.

Headache treatment

The most appropriate treatment for a headache will depend on several factors, including the type and frequency with which the headache occurs and what causes it.

Treatment can include education, counseling, stress management, biofeedback, and medications.

The treatment prescribed for you will be designed to meet your specific needs.

Headache education includes identifying and recording what triggers the headache, such as lack of sleep, not eating at regular times, eating certain foods or additives, caffeine, environment, or stress.

Headache triggers should be avoided – this is the first step in treating headaches.

Counseling in the form of individual sessions, group therapy, or support groups can help you identify headache triggers and teach you helpful coping techniques.

To successfully treat headaches, it is important that you identify the causes that trigger the headaches.

Ways to cope with or eliminate stressful activities or events must be learned. Relaxation techniques are helpful in managing stress and include breathing exercises, progressive muscle relaxation, mental imagery of relaxation, or relaxation to music.

Biofeedback equipment includes sensors attached to the body to examine involuntary physical responses to headaches, such as breathing, pulse, heart rate, temperature, muscle tension, and brain activity.

By learning to recognize these physical reactions and how the body responds in stressful situations, biofeedback can help you learn how to release and manage the tension that causes headaches.

There are medications that are used for the symptomatic and preventive relief of headaches.