What are the differences between types of headaches

If there's one thing that will give you a headache, it's trying to remember all of the different kinds of headaches are, and what are their causes or what are they associated with, which can involve simply drinking too much, smoking, stress or fatigue to food poisoning, fever, carbon monoxide poisoning, hypothyroidism, and so on.

Basically, any headache is generated pain originating from structures in the head such as the venous sinuses, the tributary veins, the dura at the base of the brain, the arteries within the meninges, or the subarachnoid space. These are all sensitive to stimulation and cause pain. Plus, there are trigeminal, vagus, and upper cervical nerves that can cause pain if under tension, inflamed or compressed.

Tension headaches are the most common. They're also very poorly understood and not treated very effectively. They happen just from fatigue, stress, worry. Usually they go away with stress-reduction techniques and relaxation, antidepressants or antianxiety drugs. They can last for a night, for a week, or even for years. It usually feels kind of like you have a gradual increase in nonthrobbing pressure or tightness in the head, which varies in intensity.

Migraines are a different story. For one thing, it's localized to one side of your head, like behind an eye or ear, and can result in throbbing-to dull pain and nausea or vomiting. Usually, children and young adults get them, as well as women beginning a premenstrual part of their cycles. A migraine is thought to happen due to arteriolar constriction and decreased blood flow in the head.

A classic migraine will have some typical foreboding with cravings, drowsiness or depression, and include light sensitivity or bright zigzag lines. The migraine usually lasts about 20 to 30 minutes.

A complicated migraine, or neurological migraine, involves symptoms similar to classic migraine, but with neurological symptoms. The extras include lip, face, hand and leg tingling as well as weakness or paralysis (like a stroke). There may be problems with a person's speech. It can last minutes or hours.

Cluster headaches can be difficult to treat. They are like migraines, but happen usually two or three hours after falling asleep. The person wakes up with steady, intense pain in an orbit and with flowing tears and one stuffed nostril that runs later on in the day. He or she will also probably have a constricted eye pupil, a drooped eyelid and a flushed cheek on the same side. The whole episode can last 10 minutes to 2 hours. Treatment can include antidepressants or corticosteroids. It's often called the "suicide headache" because of its intensity.

Reference

Nowak et al.