Headache

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Diagnosis

If you have migraines or a family history of migraines, a doctor trained in treating headaches (neurologist) will likely diagnose migraines based on your medical history, symptoms, and a physical and neurological examination.


If your condition is unusual, complex or suddenly becomes severe, tests to rule out other causes for your pain might include:


Magnetic resonance imaging (MRI). An MRI scan uses a powerful magnetic field and radio waves to produce detailed images of the brain and blood vessels. MRI scans help doctors diagnose tumors, strokes, bleeding in the brain, infections, and other brain and nervous system (neurological) conditions.

Computerized tomography (CT) scan. A CT scan uses a series of X-rays to create detailed cross-sectional images of the brain. This helps doctors diagnose tumors, infections, brain damage, bleeding in the brain and other possible medical problems that may be causing headaches.


Treatment

Your head hurts. Again. The first step in foiling your frequent headaches is determining what type of headache you have. Sometimes headaches are a symptom of another disease or condition; sometimes there's no clear cause.


Take a close look at your headache signs and symptoms. Keeping a headache diary might help determine your headache type. Note when your headaches occur, your symptoms, and potential triggers, such as food, stress or changes in sleep.


There are many types and sub-types of headaches. Chronic daily headaches, which occur 15 days or more a month, are one sub-type. Tension-type headaches and migraines are also common sub-types of headaches. They can both be chronic, though they aren't always. Other types of chronic daily headaches include:


Hemicrania continua, a one-sided headache that can feel like a migraine

Primary stabbing headaches, which last for a few seconds and can occur several times throughout the day

Primary exertional headaches, caused by exercise

Chronic paroxysmal hemicranias, sharp, one-sided headaches that can cause tearing or a congested nose

Medication overuse headaches, which occur from overusing pain medications for headaches for at least three months. These headaches occur at least 15 days out of the month.

Other headache types include:


Cluster headaches, which cause severe pain on one side of the head and occur off and on for weeks over the course of a few months. Cluster headaches are associated with one or more signs and symptoms, such as tearing, nasal congestion and nasal discharge. These occur on the same side as the pain.

Tension-type headaches

Tension-type headaches, the most common variety of headaches:


Might be felt as a tight band of pain around your head, a dull ache or pressure

Might cause mild to moderate pain on both sides of the head

Vary widely in frequency

Can be occasional

May occur more than 15 days a month (chronic)

Last from 30 minutes to a week

Treatment

Most occasional tension-type headaches are easily treated with over-the-counter medications, including:


Aspirin

Ibuprofen (Advil, Motrin IB, others)

Acetaminophen (Tylenol, others)

Daily prescription medications, including tricyclic antidepressants, might manage chronic tension-type headaches. Alternative therapies aimed at stress reduction might help. They include:


Cognitive behavioral therapy

Biofeedback

Massage therapy

Acupuncture

Migraines

Migraines are another common type of headache. They affect three times more women than men. Migraines typically:


Cause pain that is moderate to severe

Pulsate

Cause nausea, vomiting, or increased sensitivity to light or sound

Affect only one side of your head, but can affect both sides

Worsen with activity such as climbing steps

Last from four to 72 hours without treatment

Treatment

Migraine treatment is aimed at relieving symptoms and preventing additional attacks. If you know what triggers your migraines, avoiding those triggers and learning how to manage them can help prevent migraines or lessen the pain. Treatment might include:


Rest in a quiet, dark room

Hot or cold compresses to your head or neck

Massage and small amounts of caffeine

Over-the-counter medications such as ibuprofen (Advil, Motrin IB, others), acetaminophen (Tylenol, others) and aspirin

Prescription medications including triptans, such as sumatriptan (Imitrex) and zolmitriptan (Zomig)

Preventive medications such as metoprolol (Lopressor), propranolol (Innopran, Inderal, others), amitriptyline, divalproex (Depakote), topiramate (Qudexy XR, Trokendi XR ,Topamax) or erenumab-aooe (Aimovig)