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Causes
By Mayo Clinic staffYour headache symptoms can help your doctor determine the cause and the appropriate treatment. Most headaches aren't the result of a serious illness, but some may result from a life-threatening condition requiring emergency care.
Headaches are generally classified by cause:
Primary headaches
A primary headache is caused by dysfunction or overactivity of pain-sensitive features in your head. A primary headache isn't a symptom of an underlying disease. Chemical activity in your brain, the nerves or blood vessels of your head outside your skull, or muscles of your head and neck — or some combination of these factors — may play a role in primary headaches. Some people may carry genes that make them more likely to develop such headaches.
The most common primary headaches are:
- Cluster headache
- Migraine (with and without aura)
- Tension headache (medically known as tension-type headache)
- Trigeminal autonomic cephalalgia (TAC), including cluster headache and paroxysmal hemicrania
There are other headache patterns that are generally considered types of primary headache but are less common. These headaches have distinct features, such as an unusual duration or pain associated with a certain activity. Although these headaches are generally considered primary, each of them could be a symptom of an underlying disease. These headaches include:
- Chronic daily headaches
- Cough headaches
- Exercise headaches
- Hypnic headaches (headaches that awaken a person at night)
- Sex headaches
Some primary headaches can be triggered by lifestyle factors, including:
- Alcohol, particularly red wine
- Certain foods, such as processed meats that contain nitrates
- Changes in sleep or lack of sleep
- Poor posture
- Skipped meals
- Stress
Secondary headaches
A secondary headache is a symptom of a disease that can activate the pain-sensitive nerves of the head. Any number of conditions — varying greatly in severity — may cause secondary headaches. Sources of secondary headaches include:
- Arterial tears (carotid or vertebral dissections)
- Blood clot (venous thrombosis) within the brain — separate from stroke
- Brain aneurysm (a bulge in an artery in your brain)
- Brain AVM (arteriovenous malformation) (an abnormal formation of brain blood vessels)
- Brain tumor
- Carbon monoxide poisoning
- Chiari malformation (structural problem at the base of your skull)
- Concussion
- Encephalitis (brain inflammation)
- Giant cell arteritis (inflammation of the lining of the arteries)
- Glaucoma
- Hangovers
- Influenza (flu)
- Intracranial hematoma (blood vessel ruptures in the brain)
- Medications to treat other disorders
- Meningitis (inflammation of the membranes and fluid surrounding your brain and spinal cord)
- Monosodium glutamate (MSG)
- Overuse of pain medication
- Post-concussion syndrome
- Pressure from tight-fitting headgear, such as a helmet or goggles
- Pseudotumor cerebri (increased pressure inside the skull)
- Sinus inflammation and congestion
- Stroke
- Trigeminal neuralgia (disruption of the nerve connecting the face and brain)
Specific types of secondary headaches include:
- External compression headaches (a result of pressure-causing headgear)
- Ice cream headaches (commonly called brain freeze)
- Rebound headaches (caused by overuse of pain medication)
- Sinus headaches (caused by inflammation and congestion in sinus cavities)
- Spinal headaches (caused by low levels of cerebrospinal fluid, possibly the result of trauma, spinal tap or spinal anesthesia)
- Thunderclap headaches (caused by low levels of cerebrospinal fluid, possibly the result of trauma, spinal tap or spinal anesthesia)
Causes shown here are commonly associated with this symptom. Work with your doctor or other health care professional for an accurate diagnosis.
- Bajwa ZH, et al. Evaluation of headache in adults. http://www.uptodate.com/home/index.html. Accessed Dec. 13, 2010.
- Anttila V, et al. Genome-wide association study of migraine implicates a common susceptibility variant on 8q22.1. Nature Genetics. 2010;42:869.
- NINDS meningitis and encephalitis information page. National Institute of Neurological Disorders and Stroke. http://www.ninds.nih.gov/disorders/encephalitis_meningitis/encephalitis_meningitis.htm. Accessed Dec. 23, 2010.
- NINDS stroke information page. National Institute of Neurological Disorders and Stroke. http://www.ninds.nih.gov/disorders/stroke/stroke.htm?css=print. Accessed Dec. 23, 2010.
- Taylor FR. Tension-type headache in adults: Pathophysiology, clinical features, and diagnosis. http://www.uptodate.com/home/index.html. Accessed Dec. 13, 2010.
- Approach to the patient with headache. The Merck Manuals: The Merck Manual for Healthcare Professionals. http://www.merck.com/mmpe/sec16/ch216/ch216a.html. Accessed Dec. 23, 2010.
- Cluster headache. The Merck Manuals: The Merck Manual for Healthcare Professionals. http://www.merck.com/mmpe/sec16/ch216/ch216b.html. Accessed Dec. 23, 2010.
- Headache Classification Subcommittee of the International Headache Society. The international classification of headache disorders: 2nd edition. Cephalalgia. 2004;24(suppl):9.
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