Headache Clinic
Types and Symptoms of Headache

Overview

The main symptom in the diagnosis of headache is pain. Beyond that, identification of headache types is based on how the headache presents.

The crucial distinction physicians make in diagnosing a headache is whether it is secondary (due to some other, underlying cause, like a tumor, infection, bleeding, or inflammation) or primary (not due to some other underlying cause). Secondary headaches include things like meningitis, subarachnoid hemorrhage, and brain tumors. They are much rarer than primary headaches which include migraine, tension-type headaches, and cluster headaches. There are also many other headache types in each group.

A physician determines whether a headache is primary or secondary by knowing the patient’s headache history.  For example, someone who has had headaches for years is not as likely to have a secondary headache as someone whose headaches started a few weeks ago.  There are numerous scenarios that a clinician must sort through before coming to a diagnosis. Therefore, it is imperative to have a skilled and experienced person listening to your history.

When appropriate your doctor will supplement the history and examination with blood tests and imaging studies. The selection of these tests is based on information learned during the history and physical examination. They can include anything from genetic testing to measures of clotting and inflammation to MRI’s with special software to look at venous and arterial blood flow.

While a number of headache types are described in the following pages, it is important to remember that few individuals have all the elements or only the elements of one particular headache type.  It is the skill and experience of the headache specialist that narrows the field to the most likely diagnosis, and it is that diagnosis that guides treatment.

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