Common Medical Conditions

Headache: Causes and Types

Written by Dr. Manu Wilfred and medically reviewed by Dr. Sneha Kannan

Image: Headache: Causes and Types

Headache is one of the most common complaints for which patients seek medical attention. The underlying cause could be neurological, ENT-related, systemic diseases or idiopathic (cause not known).

Causes of Headache

  1. Tension-type.
  2. Migraine.
  3. Cluster type.
  4. Sinusitis.
  5. Systemic infection.
  6. Head injury.
  7. Vascular disorders.
  8. Tumors.

How to Differentiate?

The first step is to differentiate serious from benign headaches. Some of the symptoms that suggest a serious underlying disease are as follows:

  • Sudden onset headache.
  • Worst ever headache.
  • Vomiting before headache.
  • Pain interfering with sleep.
  • Headache with fever.
  • Patient above the age of 55.

Location of Pain

Sometimes, the site of the pain can give us a clue to the diagnosis, like temporal region in temporal arteritis, facial pain in sinusitis, etc.

Duration of Pain

The duration of the headache becomes important like in instant onset (ruptured aneurysm), cluster headache (three to five-minute peak), and migraine (peak pain over minutes to hours).


Complete neurological and ENT examination help suspect some of the common causes of headache. In the examination, if abnormal findings are encountered, then imaging investigations are undertaken (CT/ MRI). Lumbar puncture becomes important if meningitis or encephalitis is suspected. A psychological state assessment of the patient might be needed if there is suspicion of depression.

Common types

Migraine - Typically one-sided, increased by movement, lasts for hours to days, associated with nausea or vomiting, photophobia, phonophobia, and relieved by sleep. A family history is usually present. Most patients do not complain of auras (visual zig zags). Various trigger factors like alcohol intake, lack of sleep, loud sounds, glare, and travel are implicated in the precipitation of a migraine. It is important to identify these, as avoidance constitutes an important step in the management of migraine.

Tension-type - Bilateral location, lasts hours to days, a tight band-like sensation around the head, and often precipitated by stress. Relaxation therapy can be helpful to prevent attacks.

Cluster headache- Attacks occur in clusters. Unilateral and associated with pain behind eyes, running nose, and watering from eyes. It is a rare form of a headache, and recurrence is characteristic. Alcohol and smoking may provoke an attack.

For more information consult a headaches and migraines specialist online -->

Last reviewed at: 13.Apr.2019



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