Headache types defined

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Migraine Migraine is the most common type of vascular headache. This type of headache causes a throbbing, severe pain, usually on one side of the head. Some migraines are preceded by an early warning sign called an aura--flickering points of light and jagged lines that distort vision.Most migraines are accompaniedby nausea, vomiting and sensi-tivity to light and sound. They range in frequency from one or more a month to one a year.

Migraines are thought to be caused by a fluctuation in levels of serotonin, a chemical that relays messages in the brain. The fluctuation causes blood vessels in your head first to constrict, then expand with a vengeance, putting pressure on surrounding nerves. One of the most common migraine triggers is the hormonal swings of the menstrual cycle. "About 70 percent of people with migraines are women, and of these almost 60 percent get menstrual-related migraines," says Seymour Diamond, M.D., executive director of the National Headache Foundation and director of the Diamond Headache Clinic, in Chicago.

"There's still some argument about it, but it appears that the fluctuation in hormones can causeserotonin levels to change, in turn causing the headache." In fact, the menstrual cycle was seventh on our respondents' list of most common headache triggers. Some tension headaches can be precipitated by the menstrual cycle also, says Dr. Diamond.

Migraines are also influenced by drops in barometric pressure--indeed, changes in weather were implicated as a headache trigger by 38 percent of the migraineurs in our survey and came in sixth overall of the most common headache triggers. And more than half of the migraineurs in our survey said other members of their families suffered from migraines as well. That's even more evidence of a hereditary factor in the cause of migraines, which is well documented in the scientific literature.

Tension headaches They're also called muscle-contraction headaches. The scalp, neck and face muscles tighten--feeling like a tight band around your head--and put pressure on blood vessels and nerves. The pain usually goes away once the period of stress ends. It's by far the most common type of headache, Dr. Diamond says. Thirty-three percent of our survey respondents suffered from tension headaches--one-fourth of the headaches lasting less than two hours.

Typically they can last from a half hour to several days. Although they may not be as acute as migraines, you can have tension headaches every day for years. More than half of the tension-headache sufferers in our survey said they get them more than once a week.

Anything that makes you tense--a big presentation at work, an argument with your spouse or noise from the upstairs neighbors--can ignite a tension headache. Even posture, ranked tenth by our respondents as a trigger, can give you a headache. Sitting round-shouldered at a desk all day can put a strain on neck and upper-back muscles, which in turn might lead to a headache.

Tension-migraine headaches They're the third most common type of headache reported in our survey. Also known as tension-vascular headache or mixed headache, symptoms include daily generalized headaches and periodic migraines occurring several times a month.

Cluster headaches These may be the most excruciatingly painful of all headaches--a sharp, piercing, throbbing, burning pain that bores into just one side of the head, around or behind the eyes. Nasal congestion, tearing from the eyes or a runny nose often occurs with the headache.

Unlike migraines, 90 percent of cluster headaches occur in men. Although their cause is uncertain, researchers have found that they are more common in spring and fall, when there are changes in the number of daylight hours.

Cluster headaches usually last only about 30 to 45 minutes but rarely go away for more than three hours. They can occur several times a day on consecutive days, for periods of weeks or months.

Sinus headaches True sinus headaches usually start in the morning and get worse throughout the day. They're caused by pressure on swollen, tender sinus linings. Trapped air and pus from infected sinus tissues press against the swollen, tender sinus linings. That causes pain around the bridge of your nose and in more remote areas, too, like your jaw and ears. Thirty-seven percent of the people who answered our survey said they get sinus headaches, but according to Dr. Diamond, they're really pretty rare.

"Sinus headaches are misdiagnosed by family doctors and over-self-diagnosed," he says. "Even people with severe sinusitis--infection of the sinuses--rarely get headaches from it. More likely, you've got a migraine, cluster or tension headache."

Knowing what kind of headache you have is important if you want to find a cure that works. For example, if you think you've got a sinus headache--but you don't--sinus medication's not going to help.

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