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):
- 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
- Pressure-like pain, usually on both sides. Pain can last from 30 minutes to 7 days, usually several hours.
3. Cluster Headache
- 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 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
- 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.
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
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