Types of Headache: Classification, Locations, and Causes

First there is a tightness at the temples, as if someone is slowly drawing a band tighter. Then comes heaviness in the back of the head, and the sounds around become muffled. Ninety percent of people experience a headache at least once a year, and most often it resolves on its own.

What types of headache exist

Cephalalgia is pain above the line connecting the outer corner of the eye, the external auditory canal, and the first cervical vertebra — this is how it is distinguished from facial and cervical pain. The most common form is episodic tension-type headache.

• tension-type headache — due to tension in the muscles of the shoulders, neck, head, and jaw; it is associated with stress, depression, anxiety, overwork, lack of sleep, skipped meals, and alcohol
• migraine — affects 12–18% of the population, women three times more often than men
• cluster headache — fewer than 0.5% of people, men 5–8 times more often
• sinus headache — cluster headache is often mistaken for it

Common causes include colds and flu, stress, alcohol, awkward posture, vision problems, irregular meals, lack of fluids, excess painkillers, menstrual days, and menopause. A headache diary helps identify triggering factors.

Primary and secondary headaches

A primary headache has no organic cause: the pain-generation system itself is disrupted. Such forms account for more than 90% of cases, and by some estimates 95–98%. A secondary headache is a symptom of another disease: from cervicogenic headache, associated with neck pathology, to life-threatening conditions.

The brain does not feel pain — it has no pain receptors. The sensation comes from extracranial arteries and veins, cranial and spinal nerves, muscles of the head and neck, and the meninges; most often due to tension or irritation of receptors in the meninges and vessels.

“Red flags” are warning symptoms: they do not establish a diagnosis but become a reason for further examination. Thunderclap headache can be the only sign of subarachnoid hemorrhage, headache with fever and neck stiffness — of meningitis, confusion — of encephalitis.

Headache by location: what localization may mean

Localization is a guide, not a diagnosis: one area can hurt for various reasons, and the neurologist looks at the combination of signs.

Pain in the eye area with visual impairment, nausea, vomiting, redness of the eye, and pupil dilation is described in angle-closure glaucoma. Jaw pain when chewing and scalp tenderness are a reason to see a doctor quickly. Back of the head and neck: cervicogenic pain is associated with neck pathology, and stiffness of the neck muscles against a background of fever calls for ruling out meningitis. In older adults, pain with visual impairment and problems with the lower jaw may be a sign of giant cell arteritis. Worsening on bending, coughing, and changing body position suggests possible increased intracranial pressure: such headaches are worse in the morning and accompanied by vomiting.

Medication-overuse headache

This is a secondary headache from excessive use of painkillers. The paradox: the remedy against pain itself maintains and intensifies it. Excess analgesics are on the list of common causes alongside stress and lack of fluids.

When a headache requires a neurologist's examination

A routine visit is needed if the headache recurs regularly or worsens despite attempts to manage it. An urgent appointment is needed for visual problems, for pain from coughing, sneezing, bending, or exertion, for vomiting, for jaw pain while eating, and for scalp tenderness. In a child, the reason is a headache that increases or wakes them at night.

Diagnosis is handled by a neurologist. A cephalalgist is a neurologist specializing in the diagnosis and treatment of headache. Certain types, such as spinal (post-dural puncture) headache, require examination by a doctor.

A headache by itself is not a reason to call an ambulance. Call 103 or 112 if seizures appear, numbness or weakness in the body or face, the pain began suddenly and was extremely severe, there was a head injury in the last three months, speech, balance, gait, or memory is impaired, drowsiness or confusion has set in, vision has been lost, a rash has appeared that does not blanch under glass, very high fever, neck stiffness, or intolerance of bright light.

This text is for reference: it helps you recognize your symptoms, but does not replace a doctor's consultation.

This content is for reference and does not replace a doctor's consultation. Medical disclaimer