Headache is defined as sharp, dull or throbbing pain in any region of the head. It can occur on either one side or on both sides. Headaches can be broadly classified into two types: Primary headache and secondary headache.
Primary headaches comprise of 90% of all headaches which are recurrent and benign without any underlying disease. Following are major types of primary headache:
1) Tension-type headache: It the most common type headache which is non-pulsating in nature and can involve both sides and usually not accompanied with other symptoms.
2) Migraine headache: Migraine headache is a common type which is pulsating or throbbing like in nature predominantly involves one side of head. It can be associated with nausea, vomiting, lightheadedness, sensitivity to light or sound.
3) Cluster headache: It is a rare type neurovascular headache which occurs for a short duration and is characterized by severe excruciating pain around the eyes. It is usually associated with tearing of eye and runny nose on the affected side.
4) Trigeminal neuralgia: See Trigemnal Neuralgia.
5) Occipital neuralgia: See Occipital Neuralgia.
6) Secondary headaches: These occur in the setting of an underlying disease. Possible causes of secondary headache include sinusitis, brain tumor,
intracranial hemorrhage, brain aneurysm or arteriovenous malformation, stroke, concussion, carbon monoxide poisoning, Meningitis.
The diagnosis of headache is done by clinical history alone in most cases. If there is presence of any red flag like neurologic symptoms, sudden onset, onset of headache after age of 40 or history of recent trauma, neuro imaging is warranted to rule out any secondary causes. A lumbar puncture can be performed if an infectious cause is suspected.
Treatment of headache depends on the type of primary headache or underlying cause in case of secondary headache.