Primary Headache

Primary headache is a headache not caused by another medical condition. Neurological examination, results of CT, MRI and other tests are usually normal (1). Your doctor can make a diagnosis on the basis of your personal medical history and physical examination. Primary headaches include (2):

1. Migraine

Symptoms:

  • Aura (for example, flashing lights) within 1 hour before a headache onset. Often there is no aura.
  • Pounding, throbbing pain, usually on one side of the head (sometimes on both sides), lasting from 4 to 72 hours.

2. Tension Headache

Symptoms:

  • Pressure-like pain, usually on both sides. Pain can last from 30 minutes to 7 days, usually several hours.

3. Cluster Headache

Symptoms (1):

  • Severe, knife-like, steady, one-sided pain around the eye or temple, lasting from 15 to 180 minutes, usually 30-45 minutes.

4. Other Trigeminal Autonomic Cephalalgias*

* Cephalalgia is a Greek term for headache. Besides a cluster headache, the following one-sided headaches arise in the Trigeminal nerve (responsible for the sensitivity of the face, mouth and nasal mucosa, ear and eye), (1):

  • CPH (Chronic Paroxismal Hemicrania); symptoms usually last from 2 to 20 minutes
  • SUNCT (Short-lasting, Unilateral, Neuralgiform headache with Conjunctival injection, Tearing, sweating and rhinorrhea); symptoms last from 15 to 60 seconds and may appear several times in an hour
  • LASH (Long-lasting Autonomic Symptoms with Hemicrania), symptoms resemble migraine, but are relieved by different drugs

5. Other Primary Headaches

Other types of headache, triggered by a certain activity, but not caused by another medical condition (2):

  • Primary stabbing headache
  • Primary cough headache
  • Primary exertional headache
  • Primary headache related to sexual activity
  • Hypnic headache, which awakens you from sleep
  • Hemicrania continua; one-sided pain lasting for more than 3 months without pain free periods
  • Primary thunderclap headache
  • New daily persistent headache (NDPH); chronic headache with acute onset

Secondary Headache

Secondary headache results from a more or less obvious medical condition, like:

  • Head/neck injury
  • Blood vessel disorders on the head or in the neck
  • Headache caused by a disorder of the skull, facial bones, eyes, ears, nose, sinuses, teeth, mouth
  • Disorders within the head (intracranial disorders)
  • Substance use or withdrawal
  • Infection
  • Metabolic disorders
  • Headache in psychiatric disorders

A cause of secondary headache can be usually determined from a patient’s history, or by investigations, like CT, MRI, blood or urine test, and so on. Detailed description of secondary headaches (page 55)

Cranial Neuralgia and Central Causes of Facial Pain

Cranial neuralgia is an intense, electro-shock-like pain, affecting the area innervated by a particular cranial nerve. Examples:

  • Trigeminal neuralgia is a shooting pain in the face
  • Glossopharyngeal neuralgia is a shooting pain in the ear or throat, triggered by swallowing,
  • Occipital neuralgia: constant or shooting pain on the back of the head
  • Pain related to Herpes zoster
  • Burning mouth syndrome
  • Headache triggered by cold stimuli
  • Detailed list of cranial neuralgias (page 124)

Related Articles:

References:

  1. Types of headache  (clevelandclinicmeded.com)
  2. Types of headache  (i-h-s.org)
  3. Trigeminal autonomic cephalalgia  (hacoop.org)
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Article reviewed by Dr. Greg. Last updated on March 24, 2010