Headache

Headache can have many causes. The most common types are tension headache and migraine. Both are more common in women. Age and genetics also matter.

A headache means that there is pain in the head. This encompasses a wide range of different conditions, from the very common (tension headaches) to the relatively rare but serious (brain tumors). There may be other symptoms associated with the headache.

The most common causes of headache are tension headaches and migraine headaches. Tension headaches have long been thought to be caused by muscle tension in the neck, shoulders, scalp, and face, although some experts now question this view, and believe that tension headaches result from an increased sensitivity to pain and stress. Tension headaches are strongly associated with stress, and may also be associated with poor postural habits.

Migraine headaches are associated with nausea and vomiting, sensitivity to light and sound, and fatigue. Sometimes, patients experience unusual sensory sensations, like seeing patches of light that aren’t there. Scientists are not exactly sure what causes migraines. They may be related to changes in blood flow in the brain, imbalances in various brain chemicals, and changes in neural pathways involved in pain. Many people have particular migraine triggers, such as certain foods or beverages, changes in sleep patterns, stress, hormonal changes, or other factors. When patients with migraine encounter their triggers, they’re more likely to have a migraine.

The risk factors for headache include:

• Gender
• Age
• Genetics
• Hormonal changes

Women are more likely than men to have both tension and migraine headaches, although tension headaches are very common in both genders.

Tension headaches are most common during middle age. This may be related to the increased stress during this time of life, when many people are caring for both children and aging parents while also managing a career. Migraines usually begin during adolescence, although they can also start in early adulthood; it’s rare for someone older than 40 to begin having migraines if they haven’t previously experienced them.

Genetics appears to play an important role in migraine. Most patients with migraine headaches have at least one relative who also gets them. Research into which genes are involved and how they cause migraine is still ongoing.

Migraines are often associated with hormonal changes. For women with migraines (the majority of migraine patients), headaches are often more frequent at a particular time of the menstrual cycle, often near the onset of menstruation (when hormonal changes occur most rapidly). Many women find that their migraines change during pregnancy; some women get fewer migraines during pregnancy, while others get more. Most women get fewer or no migraines after menopause.

Besides migraine headaches and tension headaches, there are a few other types of headaches. A severe headache may be caused by a brain tumor, infection (such as meningitis), a stroke, or another serious health problem. In this case, the headache will be different from other previous headaches, often being described as “the worst headache of my life,” and will also be associated with other symptoms.

References

National Institute of Neurological Disorders and Stroke (NINDS). “NINDS Headache Information Page.” NINDS website (2015). http://www.ninds.nih.gov/disorders/headache/headache.htm

Mayo Clinic Staff. “Migraine: Definition.” Mayo Clinic website (2013). http://www.mayoclinic.org/diseases-conditions/migraine-headache/basics/definition/con-20026358

Mayo Clinic Staff. “Tension headache: Definition.” Mayo Clinic website (2013). http://www.mayoclinic.org/diseases-conditions/tension-headache/basics/definition/con-20014295

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