Causes of Headache
There are many differentcauses of headache. Headache is an extremely common symptom, experienced in one form or another by most people at one or more time in their life. The vast majority of headaches experienced by most people are benign tension headaches which are a nuisance but harmless, not associated with any serious underlying nervous system diseases. However, fortunately relatively rarely, some types of headache can be associated with severe, potentially life-threatening neurologic disease, such as meningitis, aneurysms and brain tumors, to name a few.
While all of these causes of headache have pain in the head as a common symptom, all vary somewhat in other associated symptoms that can set them apart from each other. Read on to learn more about the different types, how they differ and their implications for your health
Types of Headache
- Benign Tension Headache: The most common type of headache, most people will experience a tension headache in their lifetime. Also called stress headaches, these benign headaches can occur sporadically or be associated with fatigue, emotional or mental stress or concentration, staring at a computer screen too intensely, or other illness (such as a flu). They are not associated with any underlying brain disease, tumor, hemorrhage or anything else. The vast majority of headaches are of this type. They often respond well to rest and relaxation and simple, over-the-counter analgesic medications (acetaminophen, ibuprofen, etc.).
- Migraine Headache: Migraine headaches are another common type of headache which occur more commonly in women but can occur in men as well. In women they are often associated with hormonal changes and thus often occur at particular points in their menstrual cycle. Unlike tension headaches, they can be associated with other symptoms such as nausea and vomiting, visual changes (scotoma) and photophobia and thus can be confused for more severe neurological disease. The character of the headache itself can vary, most commonly only involving one side of the head but they can involve both sides. The intensity of head pain can vary as well. While some people complain more about the nausea and other symptoms, some complain of debilitating pain.
- Cluster Headache: One of the rare types of headaches, cluster headaches can be very painful and tend to occur only on one side in the area of the eye. They are often described as a stabbing or shooting pain behind the eye. They can often be associated with other symptoms such as swelling and/or redness of the eye and surrounding tissues of the face on that side.
- Meningitis Headache: Meningitis is an infection of the membranes covering the brain and spinal cord. It can be caused by viruses or bacteria. Either type cause headache and can cause fever, neck stiffness/pain and a deteriorating level of consciousness. While viral meningitis tends to be much less severe and resolve completely on their own, bacterial meningitis is a medical emergency and potentially fatal if not treated promptly and appropriately.
- Subarachnoid Hemorrhage Headache: Hemorrhage into the space around the brain typically causes a sudden onset of a very intense, stabbing headache, often described by patients as "the worst headache of my life". Even in patients who experience frequent headaches such as migraines, they usually say that the character of this headache is quite different and can be even more painful. It can be associated with neck stiffness/pain, nausea and vomiting and deteriorating level of consciousness. Most commonly, spontaneous subarachnoid hemorrhage such as this is due to the rupture of a brain aneurysm.
- Brain Tumor Headache: Many patients with a brain tumor experience headache. The specific character of these types of headache can be hard to distinguish from benign headaches although in some patients they describe the headache being worse when lying down or sleeping, awakening them from sleep or being worst in the morning when they wake. They may also be associated with other symptoms referable to the nervous system.
- Hydrocephalus: Hydrocephalus is an abnormality in the flow of fluid in and around the brain and spinal cord, called the cerebrospinal fluid. It can be caused by many different pathologies. As the fluid builds up, pressure within the head rises, causing a headache. It can also be associated with nausea and vomiting and, as the pressure gets very high, deteriorating level of consciousness.
- Temporal Arteritis: Temporal arteritis, or giant cell arteritis, is an autoimmune disease of the blood vessels. As the name implies, one of the most common arteries involved is the temporal artery supplying the scalp on the side of the head. This can cause pain in that area which could be described as a headache. Typically, these patients will have tenderness on the side of the head in the area of the superficial temporal artery. This disease is more common in the elderly.
- Other Intracranial Lesions: Other disease within the head can cause headaches either due to their mass effect or due to bleeding. Large aneurysm, even without rupturing, can sometimes cause headache.Arteriovenous malformations and cavernous malformations can cause headache, particularly if they bleed. Bleeding is often accompanied by other neurological symptoms as well.
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