Headaches Classification Chart

Headaches Classification , Cause, Stats, Location, Symptoms- Reference

National Headache Foundation-2008

Classification   Cause  Location  Symptoms  Traditional Treatment 
I.PRIMARY         
Tension*90% of adults will have *Most Common

* Primarily Women

*Uncertain*Stress

*Leads to contraction of muscles covering skull

*Depression

*Back of head(trapezius)*Temples(jaw muscles)

*Forehead

*Band like pressure at the back of head  or settling over the *Dull, non-throbbing pain *Frequently bilateral*Associated with tension

* Degree of severity remains constant

Rest, aspirin, acetaminophen, ibuprofen, naproxen sodium, combinations of analgesics with caffeine, ice packs, muscle relaxants. Antidepressants if appropriate, biofeedback, psychotherapy
Migraine *12% of the population (US)will have

*Equally affects boys and girls before puberty

*After puberty up to 18% of women and 6% of men will experience

Hormonal changes that cause contraction( aura ie spots, cold hands or feet and difficulty concentrating)  of blood vessels, dilation ( Pain ) *Certain foods *The Pill *Menopausal hormones*Excessive hunger *Changes in altitude, weather

*Lights

* Excessive smoking *Emotional stress. *Hereditary component

*Often one sidedBut may affect the whole head *Severe  throbbing pain*Often accompanied by nausea, vomiting, cold hands, sensitivity to sound and light.

*May have aura preceeding

Note because of the two phases and different hormones relating to each phase different treatments can be helpful at different times of the migraine.Acute: Ice packs; isometheptene mucate, combo pdts containing caffeine, ergotamine, DHE injectable and nasal spray, 5-HT agonists; analgesics or medications, which constrict the blood vessels. For prolonged attacks steroids may be helpful.

Prevention:Betablockers (propranolol, timolol), anti-convulsant (divalproex sodium), Calcium blockers and NSAIDs

Cluster* 0.1% of the population

* Estimated 85% are men

*Average age of cluster headache sufferers is 28-30

*Uncertain*Alchohol or Smoking

*Abnormal activity in hypothalamus ( biological clock)

*Run in families

*May be triggered by sleep patterns or medications ie nitroglycerin

*Excruciating pain in vicinity of one eye ( hot poker like sensation) * Watering of eye and nose with nose congestion, flushing of face  *Pain frequently develops during sleep and may last for several hours* Attacks occur every day for weeks/month, then disappear for up to a year

*Restless, pacing, banging head on wall

Acute:Oxygen, ergotamine, sumatriptan or intranasal application of local anesthetic agentPrevention:  Use of steroids, ergotamine, calcium channel blockers and lithium.
Exertion Headaches*10% caused by organic diseases (aneurysms, tumors, or bloodvessel malformation)

*90% are related to migraine or cluster headaches 

*Physical Exertion active( sexual intercourse) or passive ( sneezing, bowl movement`s , coughing)   *Generalized head pain of short duration (minutes to 1 hour) *Acute:aspirin, indomethacin, or propranolol* Extensive testing to determine the cause

*Surgery to correct organic disease is occasionally indicated.

II.SECONDARY*Infection

*Tumor

*Medication & Drugs

*Changes in body`s environment

*HEENT

*Psychiatric

*Bleeding in Brain

 

*Head and neck trauma ( concussion, whiplash)*Blood vessel problems in the head and neck ( stroke)

*Non blood vessel related ( tumors, seizures)

*Medications & Drugs

*Infections ( meningitis, encephalitis, pneumonia, flu, cold)

*Changes in the body’s environment ( high bp, dehydration, hypothyroidism)

*Problems with the eyes, ears, nose, throat, teeth and neck

*Psychiatric Disorders

     
Allergy  & Sensitivity Headaches  *Allergens     Antihistamine medication; topical, nasal cortisonerelated sprays or desensitization injections
Aneurysm  *Caused by balloon-like weakness or bulge in blood-vessel wall*May rupture (stroke) or allow blood to leak slowly

* Congenital tendency. Extreme hypertension

  *May mimic frequent migraine or cluster headaches, *Stroke-resulting in a sudden, unbearable headache, double vision, rigid neck. Individual rapidly becomes unconscious.  
Fever Headaches 

 

 

 

 

  

Sinus Headache

Infection   Generalized head pain that develops with fever. Caused by swelling of the blood vessels of the headGnawing pain over nasal area, often increasing in severity throughout day. Caused by acute infection, usually with fever, producing blockage of sinus ducts and preventing normal drainage. Sinus headaches are rare. Migraine and cluster headaches are often misdiagnosed as sinus in origin. acetaminophen, NSAIDs, antibiotics
Hypertension Headaches 

 

   
Generalized or “hairband” type pain, most severe in the morning. Diminishes throughout day.
 

 

 Manage BP.
Hangover Headaches  Alcohol, which causes dilation and irritation of the blood vessels of the brain and surrounding tissue.     Migraine-like symptoms of throbbing pain and nausea not localized to one side. Liquids (including broth). Consumption of fructose (honey, tomato juice are good sources) to help burn alcohol
Caffeine- Withdrawal Headaches  Caffeine.    Throbbing headachecaused by rebound dilation of the blood vessels, occurring multiple days after consumption of large quantities of caffeine.  
Post-Traumatic Headaches  Localized or generalized pain, can mimic migraine or tension-type headache symptoms. Headaches usually occur on daily basis and are frequently resistant to treatment.  Pain can occur after relatively minor traumas. Cause of pain is often difficult to diagnose.   Possible treatment by use of antiinflammatory drugs, propranolol, or biofeedback.
Hunger Headaches  Pain strikes just before mealtime. Caused by muscle tension, low blood sugar, and rebound dilation of the blood vessels, oversleeping or missing a meal.      Regular, nourishing meals containing adequate protein and complex carbohydrates
Eyestrain Headaches  Muscle imbalance. Uncorrected vision, astigmatism  Usually frontal, bilateral pain, directly related to eyestrain. Rare cause of headache.   Correction of vision.
HormonalMigraine-type pain that occurs shortly before, during, or immediately after menstruation or at mid-cycle (at time of ovulation  Fluctuations in Estrogen  Migraine Like   Small doses of vasoconstrictors and/or anti-inflammatory drugs before and during menstrual period may prevent headaches. Hysterectomy does not cure menstrual headaches
         
III. Cranial Neuralgias, Facial Pain, Other Headaches  *Cranial Neualgias-Inflammation of nerves of head and upper neck    .    
Temporomandibul ar Joint (TMJ) Headaches  Caused by malocclusion (poor bite), stress, and jaw clenching.    A muscle-contraction type of pain, sometimes accompanied by a painful “clicking” sound on opening the jaw. Infrequent cause of headache. Relaxation, biofeedback, use of bite plate. In extreme cases, correction of malocclusion
Tic Douloureux Headaches  unknown. Pain from chewing, cold air, touching face. If under age 55, may result from neurological disease, such as MS.    Short, jab like pain in trigger areas found in the face around the mouth or jaw. Frequency and longevity of pain varies. Relatively rare disease of the neural impulses; more common in women after age 55. Anticonvulsants and muscle relaxants. Neurosurgery
Arthritis Headaches  Intensifies on movement. Caused by inflammation of the blood vessels of the head or bony changes in the structures of the neck. Pain at the back of head or neck.   Anti-inflammatory drugs, muscle relaxants.
Temporal Arteritis  Cause is unknown. May be due to immune disorder . Pain, often around ear, on chewing. A boring, burning, or jabbing pain caused by inflammation of the temporal arteriesWeight loss, eyesight problems. Rarely affects people under 50. Steroids after diagnosis. Confirmed by biopsy.