Types of headache
1. Big picture
Headache classification is an exam topic because the first clinical task is not to give analgesics; it is to decide:
Is this a primary headache, or is it a symptom of another dangerous disease?
The key division is:
| Main group | Meaning | Treatment logic |
|---|---|---|
| Primary / idiopathic headache | The headache itself is the disease; no structural lesion explains it | Treat the headache syndrome |
| Secondary / symptomatic headache | Headache is a symptom of another disorder | Treat the underlying cause |
| Cranial neuralgias and facial pains | Pain from cranial nerves or facial pain syndromes | Treat the neuralgia/facial pain mechanism |
The most common primary headaches are:
-
Tension-type headache
-
Migraine
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Cluster headache and other trigeminal autonomic cephalalgias
The most dangerous secondary headaches to recognize are:
-
Subarachnoid hemorrhage
-
Intracerebral hemorrhage
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Meningitis/encephalitis
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Brain tumor or raised intracranial pressure
-
Cerebral venous sinus thrombosis
-
Giant cell arteritis
-
Acute glaucoma
-
Cervical artery dissection
-
Hypertensive crisis/PRES
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