There are a variety of different Headaches which can affect individuals. The most common are migraine headaches and Tension headaches. Headaches can be classified as either primary or secondary headaches. Primary headaches include migraines, tension type headaches, and cluster headaches. Secondary headaches include head trauma, neck trauma or injury (ie: following whiplash injury), occipital neuralgia, cranial masses, post dural puncture headaches, and others.

Migraines – Migraine headaches are extremely common and lead to decrease function and missed days from work. Migraine headaches may present with or without an aura. An Aura is a phenomenon which occurs prior to the onset of the headache such flashing lights, altered vision, weakness, altered smell, etc. Usually an aura occurs up to 1 hour prior to the onset of the headache, and this can alert the individual that a headache will follow. About 50% of individuals with migraines experience a prodrome. A prodrome will usually occur up to 24 hours prior to the headache. Patients experience altered perception, irritability or withdrawal or food craving. Other common associated symptoms are with nausea and vomiting, photophobia (sensitivity to light) and/or phonophobia (sensitivity to sound).

Common features of a migraine headache include unilateral (one sided) symptoms, the quality of the headaches are pulsating, the severity is moderate or severe and there may be associated conditions which intensify the headaches, such as exercise. Duration of Migraines are usually between 4 – 72 hours. The complete cause of migraines is still not clearly understood. There does appear to be a genetic connection with migraine headaches.

What is the treatment of headaches?

Generally, headaches are treated initially with acetaminophen, aspirin, nonsteroidal, anti-inflammatories and various combination products which generally include accommodation of the previous medications sometimes with a caffeine product. Antinausea agents can also be used to treat the associated nausea and vomiting symptoms.

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