Headache

German: Kopfschmerz

1 Definition

A headache is a painful sensation in the region of the head. It's based on the stimulation of pain-sensitive structures (calvaria, meninges, blood vessels in the brain, cranial nerves, spinal nerves). The brain tissue itself is not pain-sensitive.

2 Classification

Headache can generally be divided into:

1. Primary headache: The pain is the primary condition, with a known cause.
2. Secondary headache: Side effect of a different condition

The ICHD classification, published by the International Headache Society, provides a more detailed classification and distinguishes between 128 different kinds of headaches.

3 Etiology

Possible causes for secondary headache are:

• Orthopedic causes
  • Whiplash
  • Tense muscles of the neck
  • Degenerative changes of the cervical spine
  • Disorders of the cervical spine
  • Scoliosis
• Otorhinolaryngolic causes
  • Sinusitis
  • Vacuum headache
  • Rhinogenic headache (pathology in the inner nose)
  • Referred pain
• Systemic causes
  • Hypertension
  • Hormonal disorders
  • Infectious diseases
  • Allergies
• Neurological causes
  • Cluster headaches, "Suicide Headache"
  • Increased intracranial pressure
  • Increased intracranial volume (e.g. brain tumor)
  • Epilepsy
  • Craniocerebral injury (CCI)
  • Subarachnoid hemorrhage
  • Brain infarction
  • Meningitis
  • Cerebral arteriovenous malformation
  • Neuralgia
• Psychogenic causes
  • Stress
  • Climate
  • Sleep deprivation
• Ophthalmologic causes
  • Impaired vision
• Disorders of the teeth
  • Dysgnathia
• Toxicants
  • Alcohol
  • Drugs
  • Food
  • Noise

4 Frequent types

4.1 Migraine

• Very painful, often pulsating
• Episodic
• Occurs repetitively and one-sided
• Duration: hours up to days
• Accompanying symptoms (nausea, vomiting, light and noise sensitivity)
• Possibly neurological fits

4.2 Tension headache

• Mild or moderate intensity
• The whole head, both sides
• Constant pressure
• Occasionally up to daily (30 minutes to 7 days)
• Dull, pressing
• Often other accompanying symptoms

4.3 Cluster headache

• One-sided pain in the region of the eyes of temple
• Possibly reddening of the eyes and the face
• Increased lacrimation
• Lasts for 15 to 180 minutes
• Can occur for years

4.4 Headache caused by neck problems

• Mild to strong level of pain
• One-sided pain with one dominant side
• No regular temporal pattern
• Limited mobility in the cervical spine
• Accompanying symptoms (nausea, dizziness, impaired vision)
• Ventral translation of the head