My husband was up in the night with a bad headache. He doesn’t usually get headaches, so we were baffled. Was it because of something he ate? The cups of coffee he drank the day before? Barometric pressure? Something worrisome? Fortunately, by morning it was gone and hopefully, he won’t have another today because of his lack of sleep.
While he suffered, I researched all the possible causes of headaches, and was surprised there were so many. Most of the time they aren’t too serious, but sometimes they are and you need to get to the emergency room immediately.
I decided to write about common headaches and their causes, so contacted Dr. Eric Dinnerstein, a Maine Medical Center neurologist, for some expert advice. He explained that headaches are divided into primary and secondary headaches.
“Most headaches are primary — no lesion in the brain. They are usually not life threatening, but can be disabling. The secondary headaches are potentially dangerous and if not identified and treated may lead to long term damage.”
~ Eric Dinnerstein, MD
- Tension headache
- Most common type of primary headache. Causes mild or moderate pain in the head, neck and behind the eyes. May feel like a tight band around the forehead.
- Causes throbbing pain, usually on one side of the head. Often associated with nausea, vomiting, and extreme sensitivity to light and sound.
- Cluster headache
- Least common primary headache and the most severe. Causes throbbing or constant burning feeling behind one eye or near the eye. Attacks occur one to three times a day for a period of time that may last weeks or months.
- Hemicrania Continua
- Also uncommon. Causes constant, usually dull pain on one side of the head. May be associated with drooping eyelid, red or watery eyes, stuffy or runny nose.
Primary headaches usually develop for no obvious reason, but there is a long list of potential triggers.
Common primary headache triggers
- Certain foods, such as aged cheese, processed meats, smoked or pickled foods, nuts and chocolate and MSG, a food additive
- Glare of the sun, bright or flashing lights
- Headband, tight ponytail or braid
- Hormonal changes
- Medication side effects
- Poor posture
- Red wine or beer
- Strenuous exercise
- Sex, especially related to orgasm
- Skipping meals
- Strong odors
- Too much or too little sleep
- Weather— a change in the temperature or barometric pressure
A primary headache can be devastating, but a secondary headache could be deadly. Dr. Dinnerstein says secondary headaches are caused by an underlying disease or condition.
Possible causes of a secondary headache
- Blood clot in the brain
- Brain tumor
- Carbon monoxide poisoning
- Concussion or post concussion syndrome
- Dental problems
- Ear infection
- Head and neck trauma
- Infection, such as Lyme disease
- Inflammation of the lining of the arteries (arteritis)
- Pain medication overuse
- Panic attack
- Sinus infection
- Stroke or TIA (trans ischemic attack that may be a stroke warning)
- Toxoplasmosis (a parasitic infection)
- Tri-geminal neuralgia
When should you contact your doctor or go to the emergency room?
Here are some signs and symptoms that Dr. Dinnerstein considers important.
Call the doctor if you have
- Double vision
- Blurry vision
- A headache that gets worse when you lie down or stand up
- “The worst headache in my life”
- Headache with weakness or slurring
- Headache with inability to speak
- Headache with confusion
- Headache with balance problems
- Sudden, new severe headache
- Headache with fever, shortness of breath, stiff neck or rash
- Headache with severe nausea and vomiting
- Headache that develops after an accident or head injury
“I advise patients with those signs to seek medical attention and to be evaluated by their doctor.” ~ Eric Dinnerstein, MD
Do you have headaches? What are your triggers and your most effective treatment?
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