It's NOT All in Your Head!

On occasion, most people will experience a headache from time to time.  But those suffering from chronic headache disease, can have a difficult time deciphering between what could be a “common” occurrence type of headache and what is something more significant. 
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In this section, I will provide insight, as to what I have learned about headaches and migraine disease while on my journey.  I will also provide wonderful resources for you to explore for yourself.  

Recognizing Headaches

According to the National Headache Foundation
​ and the Association of Migraine Disorders there are approximately 150 different types of headaches.  These headaches vary greatly and that is why it is so important that those suffering get the proper care. 

As reported by the American Migraine Foundation, there are two main categories of headaches.

1. Primary Headaches – where the headache itself is the issue with no serious underlying conditions causing the symptoms or pain.  That is to say they are “benign.”  No significant illness is causing them to occur.
2. Secondary Headaches – are a headache caused from a condition or malady, such as an injury, tumor, infection, stroke, or medication.

Below is a list of some Common Headaches taken from the American Migraine Foundation and the Coalition of Headache and Migraine Patients (CHAMP)
​Below is a link to CHAMP's full Glossary of Headache Terminology​

Headache Types

​Post Traumatic Headache

OVERVIEW: This is localized or generalized pain. It can mimic migraine or tension-type headache symptoms. It usually occurs on a daily basis. Headaches are frequently resistant to treatment. Pain can occur after relatively minor traumas; however, the cause of the pain is often difficult to diagnose. 
 
TREATMENT: Use of anti-inflammatory drugs, propranolol or biofeedback

Tension-type Headache
​
OVERVIEW: This headache type is a dull, non-throbbing pain. It is frequently bilateral, associated with tightness of scalp or neck. The degree of severity remains constant. These headaches are often caused by emotional stress and depression.
 
TREATMENT: Rest; avoidance of stress; relaxation techniques; aspirin, acetaminophen, ibuprofen, naproxen sodium; combinations of analgesics with caffeine; ice packs; muscle relaxants; antidepressants if appropriate; biofeedback; psychotherapy; temporary use of stronger prescription analgesics.

New Daily Persistent Headache

OVERVIEW: This is best described as the rapid development (less than three days) of unrelenting headache. Typically, it presents in a person with no past history of headache. It does not evolve from migraine or episodic tension-type headache. It begins as a new headache. This may be the result of a viral infection. 
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TREATMENT: It can resolve on its own within several months. Other cases persist and are more refractory. This does not respond to traditional options; however, anti-seizure medications, such as Topamax or Neurontine, can be used.

Idiopathic Intracranial Hypertension
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OVERVIEW: This is a condition that occurs when pressure inside the skull increases for no obvious reason. Idiopathic intracranial hypertension is most common in obese women of childbearing age. The symptoms mimic a brain tumor; however, no tumor is present. They may include headache behind the eyes, ringing in the ears in time with the heartbeat, and brief episodes of blindness.
 
TREATMENT: The first drug is usually a type of diuretic that may reduce the production of spinal fluid. Surgery may relieve pressure. Weight loss can improve cardiovascular health and reduce the risk of complications related to obesity.

​Hemicrania Continua
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OVERVIEW: Hemicrania means one side of the head, and continua means continuous. As the name implies, hemicrania continua is a one-sided headache that is daily and continuous. It’s a primary headache disorder, which means nothing else causes it. A similar but separate disorder, paroxysmal hemicrania, also includes a one-sided headache; however, this disorder causes five or more attacks of severe pain that last up to 30 minutes a day. People with paroxysmal hemicrania usually have no pain between these attacks. Those with hemicrania continua always have some level of pain. It can be difficult to distinguish between the two disorders. The main difference is the duration of pain. Hemicrania continua needs to be present for at least three months before doctors can confirm a diagnosis.

Migraine Without Aura
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About 70-75% of patients with migraine do not
experience aura. Instead, their symptoms include
pulsing or throbbing pain (like a heartbeat) on one
or both sides of the head, together with sensitivity
to light and sound (photophobia and phonophobia)
and/or nausea and vomiting. Untreated, or incorrectly
treated, an attack of migraine can last from four hours
to three days. A diagnosis is reached by reviewing a
patient’s personal and family medical history, studying
symptoms and conducting a general and neurological
examination.

Migraine With Aura

About a quarter of people who experience migraine also
experience aura. Auras can take the form of changes in
vision that range from seeing sparkling lights, bright dots
or zig zag lines, sometimes with areas of blindness, or
they may involve tingling on one side of the body or the
inability to speak and understand clearly. Aura usually
sets in before the headache phase of a migraine attack
and can last anywhere from five to 60 minutes. Aura is
the second of migraine’s four stages, and anyone who
experiences it will confirm it is an unmistakable warning
sign that severe head pain is on its way.

Typical Aura Without Headache
​
Aura is a recurrent attack that features temporary
visual, sensory and/or speech/language symptoms
that last between 5 and 60 minutes. Typical aura
without headache, also called silent migraine, is a
migraine aura that lacks the accompanying headache.
The aura symptoms also usually happen before
migraine symptoms, like nausea and sensitivity to
light and sound, appear.

Retinal Migraine

Patients with retinal migraine experience visual
symptoms ranging from kaleidoscope-like changes
and areas of greyed out vision to complete loss of
vision. The symptoms typically evolve over minutes
and last 5-60 minutes. Unlike visual symptoms with
migraine with aura, retinal migraine symptoms are
only in one eye. Because they are rare, and because
similar symptoms may accompany a more serious
illness, if you experience these one-sided vision
changes, you should have your eyes checked as soon
as possible.

Chronic Migraine
​
More than four million American adults live with
chronic migraine—meaning they experience 15 or
more headache days per month for more than three
months with at least eight of those headache days
being a typical migraine attack. Chronic migraine
often appears in people whose less frequent
episodic migraine has worsened, so addressing risk
factors early can help prevent a patient’s migraine
transforming into chronic.

Complete Headache Glossary

This full Glossary of 150 Headache Terms is provided by CHAMP