Understanding Headaches

Dr. Coceka Mfundisi explains the differences in 9 types of headaches you might experience.

Headaches are common, often benign and self limiting pain located in the head. Busamed Dr. Coceka Mfundisi, specialist Neurosurgeon at Busamed Modderfontein says most headaches can be treated by local physicians with great success.

She says headaches can be associated with other general medical conditions. “Location is a poor predictor of the problem,” she says.

The Red Flags of a Headache
Dr. Mfundisi says patients should look out for the following symptoms:

• Early morning headaches
• Association with vomiting without gastro-intestinal problems
• Changes in vision
• Changes in body habitus
• Libido affectation
• Presence of seizures, particularly adult onset
• Presence of weakness or loss of balance

Below are 10 common types of headaches that you could experience:

Migraine
Type: Primary
Location: Unilateral, along one side of the face
Traits: Recurrent, and/or gradual onset, and/or crescendo pattern
Intensity: Moderate to severe
Duration: 4 – 72 hours
Associated symptoms: Nausea, Vomiting, Photophobia, Phonophobia
Treatment: NSAID/Aspirin + anti-emetics + hydration

Tension
Type: Primary
Location: Bilateral, around the circumference of the head
Traits: Pressure around the forehead, band-like tightness, Wax and wane-like feeling
Duration: Varies
Associated symptoms: None
Treatment: Analgesics, paracetamol

Sinus and Allergy
Type: Secondary
Location: Inside forehead and cheekbones
Traits: Deep pain, constant, yellow or green nasal discharge
Duration: varies
Associated symptoms: Sinusitis
Treatment: Supportive, analgesics, antibiotics

Cluster
Type: Primary
Location: Unilateral around and behind one eye
Traits: Quick onset, deep pain, continuous, severe intensity
Duration: 30 minutes – 3 hours
Associated symptoms: Lacrimation and nasal discharge
Treatment: Triptans + oxygen

Temporomandibular joint (TMJ)
Type: Secondary
Location: Unilateral – around the ears
Traits: Chronic, recurrent, aching
Duration: Days
Associated symptoms: Pain and difficulty chewing, inability to open mouth, tinnitus (ringing in the ears)
Treatment: NSAID + Jaw exercises

Hypertension
Type: Secondary
Location: Back of the head, mostly
Duration: Varies
Associated with: Dangerously high blood pressure
Treatment: seek immediate medical attention

Thunderclap
Type: Secondary
Location: Global, around the cranium
Traits: Sudden onset, very severe intensity, sharp pain. Maximum pain in 60 seconds.
Duration: Variable
Associated symptoms: Numbness, weakness, seizures, vomiting, neck stiffness ptosis or double vision and confusion
Treatment: Depends on the cause. This headache is associated with brain aneurysm and blocked, bleeding or ruptured blood vessels in the brain.

Headache on Both Sides of the Head
Type: Primary or secondary
Location: Bilateral, both sides of the face
Duration: varies
Associated with: exertion, caffeine, hypertension, PTSD headaches
Treatment: Analgesics

Headache on One Side of the Head
Type: Primary or secondary
Location: Unilateral, down the face
Duration: varies
Associated with: migraine, pregnancy, menstruation
Treatment: analgesics