Headache is the symptom of pain in the head, neck or face associated with or without other symptoms & signs

Symptom of pain – can be pain proper or it could be other similar symptoms like heaviness, dullness, band like tight- ness,crawling or a pricking type sensation. Different forms of headache have different such symptoms.

Other symptoms & signs – Apart from the pain, headache is often associated with other symptoms & signs like photo- phobia (sensitivity to bright light), phonophobia (sensitivity to sounds, noise), aversioin to certain smells, visual aura (a spectrum of lights/colours in specific patterns floating in front of the eyes before, or at the onset of headache), tearing of the eyes or redness around the eyes etc.

Incidence of headache : It is among the commonest neurological Symptoms in the world. Almost everyone, at some point in their Lives experiences headaches….for whatever reason.

Causes for headache : Headache occurs because various disorders cause irritation or pressure to pain sensitive structures of the head.

What are the pain sensitive structures of the head ?

They are divided into 2 –

Structures within the skull vault – venous sinuses (veins), arteries, Few cranial nerves, dura at the skull base (a layer of the skull) etc.

Structures outside the skull vault – periosteum (outer layer of skull), skin, subcutaneous tissue, muscle, few cervical nerves, arteries, eye, ear, teeth, sinuses, mucous membranes of nasal cavity etc.

Mechanism of pain – Whenever the above mentioned pain sensitive structures are stimulated due to various neurological diseases, pain is felt. This pain is transmitted mainly through the 5^th cranial nerve & rarely through the 9^th & 10^th or upper cervical nerves

What are the different types of headache & the disorders  that cause them ?

Headaches can be divided into :

1. Primary headaches 2.Secondary headaches

Primary headache – Here the headache itself is the primary problem. It is an underlying weakness and/or irritation of the  nerve. There is no other secondary disorder causing it.

Secondary headache – Here, there is a secondary disease like a tumour or clot that causes the headache & it is not a primary weakness of the nerve.

COMMON CAUSES OF PRIMARY & SECONDARY HEADACHES

I have headache. How do I know what type I am having ?

As we have discussed earlier, there are different types of Headache. In most cases, different headaches present in different ways. Some common forms are – 

Migraine – Here headache is on & off over several weeks to months, usually one half of head, gradually increases in frequency/intensity & is associated with photophobia and phonophobia (sensitivity to bright light and sound/noise). 

Tension type headache – This is usually seen almost on a daily or continuous basis, like a squeezing heaviness or a band like pressure over the forehead or center of the head. It is usually increased with physical or mental stress. There is associated  decreased food and sleep. It is seen more in women.

Sinus related headache – Here the pain is on and off, usually more frequent than migraine, but less frequent than tension type headache. Mainly felt around the eyes, cheekbones &  forehead. Almost always associated with cold, runny nose or stuffiness of the nose. It is seen more on waking up in the morning.

Cluster headache – This is a relatively rare form of headache, seen more in males. As the name suggests, this occurs very suddenly, in a cluster ie. repeated severe pricking type pain clustered around one eye. It lasts for few days and disappears just as suddenly. It comes once or twice a year in most people. There is associated watering, redness and swelling in & around the affected eye.