How are headaches classified?
Did you know that there are over 150 different types of headaches?
Headaches are typically classified according to their cause and fall into three main areas which determine their type:
Primary headaches
Primary headaches are not classified as a symptom of an underlying medical illness. Pain-sensitive structures in the head (including nerves and blood vessels) can become overactive, irritated or inflamed. Occasional headaches resolve easily with basic treatment (fluids, rest and a pain-relieving medication), while others can be somewhat debilitating.
Primary headaches are not typically life-threatening, but can be severe and intense enough to even mimic symptoms of serious conditions such as stroke.
Some of the most common primary headache types include:
- Tension headaches or tension-type headaches
- Cluster headaches
- Migraine with aura (accompanied by sensory disturbances) or without aura
- Trigeminal autonomic cephalalgia (TAC) – cluster headaches and paroxysmal hemicrania (a severe unilateral pain affecting the area around the eye, causing a headache)
Less common primary headache types that have distinct features of an underlying medical condition include:
- Cough headaches (triggered by coughing and other types of strain such as sneezing or nose-blowing)
- Chronic headaches (daily) – these include chronic migraine, and chronic tension-type headaches)
- Exercise headaches (these occur during or after intense exercise)
- Sex headaches (following sexual activity / orgasm)
Other factors and lifestyle habits can also trigger primary headaches and include things such as:
- Stress
- Changes in sleeping patterns or a lack of sleep
- Alcohol consumption (particularly red wine) and certain foods (such as meat containing nitrates)
- Skipping daily meals
- Poor posture
Secondary headaches
These headaches typically result as a symptom of an underlying medical condition or problem in the head or neck, which varies in severity. A very broad group of conditions fall into this classification of headache, ranging from a mild infection (of a tooth) or sinus problem to something more severe such as bleeding in the brain or infections like encephalitis or meningitis, which can be extremely life-threatening.
Secondary headaches types can include:
- External compression headaches (due to pressure-causing headgear such as helmets or goggles)
- Rebound headaches (due to pain medication overuse)
- Sinus headaches (due to congestion in the sinus cavities or inflammation)
- Spinal headaches (due to volume of cerebrospinal fluid or low pressure)
- Thunderclap headaches (sudden, severe headaches associated with a group of disorders that have multiple causes)
Some possible causes include:
- Dehydration
- Dental problems and infections
- Middle ear infection
- A hangover (due to excessive alcohol consumption and dehydration)
- Flu (influenza)
- Hypertension (high blood pressure)
- Panic attacks / panic disorders
- Acute sinusitis
- Blood clots in the brain (venous thrombosis)
- Brain tumour
- Concussion and post-concussion syndrome (traumatic headaches)
- Brain inflammation such as meningitis and encephalitis
- Stroke
- Arterial tears (vertebral or carotid dissections)
- Brain aneurysm (a bulge that occurs in an artery in the brain)
Facial pain and cranial neuralgias (nerve pain)
When one of 12 cranial nerves, that control muscles in the head and carry sensory signals, like pain, to and from the neck and head, becomes inflamed neuralgias (‘neur’ – nerve and ‘algia’ – pain) can occur. These types of headaches can lead to intense facial pain as a result of inflammation or irritation.