More About Headaches

A headache is pain or discomfort in the head or face. Headaches vary greatly in terms of the location and intensity of the pain, and how often the headaches occur. The brain tissue doesn’t have pain-sensitive nerve fibers and doesn’t feel pain. But, other parts of the head can be responsible for a headache including:

  • A network of nerves that extends over the scalp
  • Certain nerves in the face, mouth, and throat
  • Muscles of the head, neck, and shoulders
  • Blood vessels found along the surface and at the base of the brain

Different types of headaches include:

Migraine

In this type of headache, symptoms other than pain occur as part of the headache. Nausea and vomiting, lightheadedness, sensitivity to light (photophobia), and other visual symptoms typically occur with migraines. Migraines also have distinct phases. Not all people have each phase, however. The phases of a migraine headache may include:

  • Premonition or prodromal phase. A change in mood or behavior may occur hours or days before the headache.
  • Aura phase. A group of visual, sensory, or motor symptoms can precede the headache. Examples include vision changes, hallucinations, numbness, changes in speech, and muscle weakness.
  • Headache phase. Period during the actual headache with throbbing pain on one or both sides of the head. Sensitivity to light and motion are common, as are depression, fatigue, and anxiety.
  • Resolution phase. Pain lessens during this phase, but may be replaced with fatigue, irritability, and trouble concentrating. Some people feel refreshed after an attack, others do not.

Tension headaches

Tension headaches are the most common type of headache. Stress and tight muscles are often factors in tension-type headaches. These are common symptoms of a tension-type headache:

  • Slow onset of the headache
  • Head usually hurts on both sides
  • Pain is dull or feels like a band or vice around the head
  • Pain may involve the back part of the head or neck
  • Pain is mild to moderate, but not severe
  • Tension type headaches typically do not cause nausea, vomiting, or sensitivity to light (photophobia).

Cluster headaches

Cluster headaches usually occur in a series that may last weeks or months.

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These are the most common symptoms of a cluster headache:

  • Severe pain on one side of the head, usually behind one eye
  • The eye that is affected may be red and watery with a droopy lid and small pupil
  • Swelling of the eyelid
  • Runny nose or congestion
  • Swelling of the forehead

This often severe, throbbing type of headache is different from other types of headaches in that symptoms other than pain occur with the headache. Nausea and vomiting, lightheadedness, sensitivity to light (photophobia), and other visual disturbances are common migraine symptoms. A migraine headache may last from 4 to 72 hours.

Migraines are also unique in that they have distinct phases. Not all people have each phase, however. The phases of a migraine headache may include:

  • Premonition phase. A change in mood or behavior that may occur hours or days before the headache.
  • Aura phase. About one-third of people who have migraine headaches describe having an unusual “feeling” or aura before the headache. The aura phase includes visual, sensory, or motor symptoms that occur just before the headache. Examples include hallucinations, numbness, changes in speech, visual changes, and muscle weakness. Migraine sufferers may or may not have an aura before the beginning of the headache.

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  • Headache phase. This is the period during the actual headache. Throbbing pain occurs on one or both sides of the head. Sensitivity to light and motion is common, as are depression, fatigue, and anxiety.
  • Headache resolution phase. Pain lessens during this phase, but may be replaced with fatigue, irritability, and trouble concentrating. Some people feel refreshed after an attack, while others do not.

Headaches are classified as with or without aura.

Cluster headaches are rare when compared to other types of headaches. The pain they produce is severe and tends to recur in the same way each time. They occur in groups, or clusters, and each attack lasts about 1 to 3 hours on average. The frequency of occurrence may range from every other day to multiple times a day. Cluster periods are followed by remissions that may last months or years. 

Males are affected by cluster headaches more than females and they typically start around age 30.

Tension headaches are the most common type of headache. Stress and muscle tension are often factors in these headaches. Tension headaches typically don’t cause nausea, vomiting, or sensitivity to light. They do cause a steady ache, rather than a throbbing one, and tend to affect both sides of the head. Tension headaches may be chronic, occurring often, or every day.