How Headaches Differ

Published September 30, 2010 by anny1with1life
How Headaches Differ
Type or Cause Characteristics* Diagnostic Tests
Primary (not due to another disorder)
Cluster The pain is severe and piercing. It affects one side of the head and is focused around the eye. The pain lasts 30 minutes to about 1 hour. People with cluster headaches cannot lie down, frequently pace, and sometimes bang their heads. Headaches occur in clusters, separated by periods when no headaches occur. They are usually not worsened by light, sounds, or smells and are not accompanied by nausea and vomiting.

On the same side as the pain, the nose runs, the eye tears, the eye lid droops, and the area below the eye may swell.

Tests are the same as those for tension-type headaches.
Migraine The pain is moderate to severe. A pulsating or throbbing pain is felt on one side or sometimes on both sides of the head. The pain lasts several hours to days. Headaches may be worsened by physical activity, light, sounds, or smells and are accompanied by nausea, vomiting, and sensitivity to sounds, light, and odors. Tests are the same as those for tension-type headaches.
Attacks can occur for a long period of time, then disappear for weeks, months, or years. Often, people have a sensation that a migraine is beginning. This sensation (called a prodrome) may include mood changes, loss of appetite, and nausea. Attacks may be preceded by temporary disturbances in sensation, balance, muscle coordination, speech, or vision (such as seeing flashing lights and blind spots). These disturbances are called the aura.
Tension-type The pain is usually mild to moderate. It feels like tightening of a band around the head and affects the whole head. The pain lasts 30 minutes to several days. It may be worse at the end of the day. Headaches are not worsened by physical activity, light, sounds, or smells and are not accompanied by nausea and vomiting. CT or MRI of the head is occasionally done to rule out other disorders, particularly if the headaches have developed recently or if the symptom pattern has changed.
Secondary (due to another disorder)
Brain abscess The pain is similar to that caused by a brain tumor. However, if an abscess ruptures, acute meningitis results, causing an intense headache and a stiff neck. MRI or CT is done.
Brain tumor Pain is mild to severe and may become progressively worse. It usually recurs more and more often and eventually becomes constant without relief. People often become clumsy, weak, or confused. They may vomit or have seizures. MRI is done.
Encephalitis Encephalitis (infection of the brain) can cause headaches. MRI or CT and a spinal tap are done.
People may also have a fever. They may become very drowsy, clumsy, weak, or confused. They may vomit or have seizures. Coma can develop. Some people also have meningitis.
Eye disorders (such as iritis, glaucoma, and papillitis) The pain is moderate or severe and is often worse after using the eyes. It is felt at the front of the head or in or over the eyes. An eye examination is done.
Vision is impaired.
Giant cell (temporal) arteritis A throbbing pain is felt on one side of the head at the temple. The scalp hurts when the hair is combed, and chewing hurts. The arteries in the temples may be enlarged. The erythrocyte sedimentation rate (ESR) is determined, and a biopsy of the temporal artery is done.
Aches and pains may occur, particularly in the shoulders, thighs, and hips. Vision may be lost.
High blood pressure (hypertension) Extremely high blood pressure can cause headaches. The pain is throbbing, occurs in spasms, and is felt at the back or top of the head. Usually high blood pressure does not cause headaches. Blood pressure is measured, and blood tests and kidney function tests are done.
Intracerebral hemorrhage The pain may be mild or severe and occurs on one or both sides. CT or MRI is done.
People may become very drowsy, clumsy, weak, or confused. They may vomit or have seizures. Coma can develop.
Meningitis The pain is severe and constant and is felt over the whole head. It travels down the neck, making bending the neck to rest the chin on the chest difficult. Blood tests and a spinal tap are done.
People feel ill, have a fever, and vomit.
Sinus disorders The pain is severe and may be dull or sharp. It is felt at the front of the head. It may begin suddenly and last only a short time, or it may begin gradually and be persistent. It is usually worse in the morning and less severe in the afternoon. Cold, damp weather and lying down make the pain worse. CT of the sinuses or endoscopy of the nose may be done.
People have a runny nose, sometimes with pus or blood. They feel ill, may cough at night, and often have a fever.
Subarachnoid hemorrhage The pain is severe, constant, and widespread. It may reach its peak intensity within a few seconds. Occasionally, it is felt in and around one eye. The eyelid droops. People often describe the headache as the worst ever experienced. They may briefly lose consciousness. MRI or CT is done. If the results are negative, a spinal tap is done.
Some people are sleepy, confused, and hard to rouse. Others are restless. Later, the neck may become stiff, with a continuing headache and often with vomiting, dizziness, and low back pain.
Subdural hematoma The pain is mild to severe and intermittent or constant. It can be felt in one spot or over the whole head and travels down the neck. MRI or CT is done.
People may feel sleepy or become confused or forgetful.
Other disorders if they affect the brain (such as cancer, cryptococcosis, sarcoidosis, syphilis, and tuberculosis) The pain may be mild or severe and dull or sharp. It is felt over the whole head. A spinal tap and MRI are done.
People whose headache is caused by one of these disorders have a moderate fever and other symptoms of the disorder.
Advertisements

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s

%d bloggers like this: