Symptoms and Complications
Tension headaches generally cause a constant pressure or a "dull ache"
that affects the entire head. In most cases it begins slowly, with the ache
usually focused above the eyes. There's a feeling of tightness across the forehead
or at the back of the neck. The ache can last for hours or days at a time, with
mild to moderate pain that typically worsens by the end of the day.
Cluster headaches occur in "clusters" or groups, with pain lasting
about 20 to 90 minutes at a time. They typically start during sleep. The
ache and pain is limited to one side of the head and can be extremely severe.
They are often accompanied by other symptoms on the side of the headache such
as redness and tearing of the eye, drooping eyelid and nasal stuffiness and
dripping.
Migraines range from mild to severe. They often occur as one-sided head
pain but can sometimes affect both sides. The location, duration, and intensity
of pain vary widely from person to person as well as from one episode to another.
Migraine is usually a pulsating pain, often with other symptoms such as nausea,
vomiting, visual disturbances and hypersensitivity to light, noise and smells.
A migraine attack can last from hours to days - averaging 12 to 18 hours. They're
often so severe and incapacitating that many migraine sufferers are unable to
carry out normal daily activities.
Migraine headaches are divided into two categories: migraine with aura and
migraine without aura. Some people experience a pre-headache stage known
as an aura, which can last about 10 to 30 minutes. A typical aura includes visual
disturbances such as blind spots, zigzag flashes, and light sparks. The aura
normally clears as the headache starts, but there can be some overlap. Sometimes
the aura will occur without a headache but more often no aura occurs before
the headache.
Although headaches can be painful and debilitating, they are usually not
due to dangerous conditions. However, occasionally headaches can be a sign
of something more serious. Very severe high blood pressure (above 180/110 mm Hg),
stroke, or a brain tumor may cause headaches. Meningitis (an infection of the
brain's lining) may also cause a headache. Warning signs are a sudden onset
of headache accompanied by fever, stiff neck, and visual problems (double vision).
It's critical that you seek emergency medical care if you experience a headache
that:
- gets worse over days or weeks
- is accompanied by impaired neurological function (e.g., loss of balance,
weakness, numbness or speech disturbance) and double vision (could signal
a stroke)
- is accompanied by persistent nausea and vomiting
- is accompanied by seizures, mental disturbances, and loss of consciousness
- is associated with a fever and/or stiff neck (could signal meningitis)
- is different than the usual pattern of headaches you have experienced
- strikes suddenly with great intensity
- wakes you from sleep or is worse when you lie down