Primary Headache
Primary headache is called so as it’s a headache that is not associated to any other medical condition. And for this reason the neurological examinations, MRI and CT scans usually do reveal much. The personal medical history is studied along with physical examination for a better diagnosis of a primary headache. Primary headache can be of various types:
Migraine
Severe throbbing pain and pounding is observed on just one or either sides of the head for about 4-72 hours. Sometimes aura too is experienced following the onset of throbbing.
Tension Headache
Pressure is felt on both sides of the head with intense pain lasting for 30 minutes to several hours. This usually continues for a week.
Cluster Headache
Severe and steady pain is felt on one side of the head or around the eye or temple similar to the pain caused by poking of a knife. This can last anywhere from 15 to 180 minutes with the average duration being 30-45 minutes.
Trigeminal Autonomic Headaches
Apart from the cluster headache, some other one-sided headaches are noticed usually in the Trigeminal nerve. These include the CPH, SUNCT and LASH that can be easily relieved by various drugs.
Other Primary Headaches
Apart from the above mentioned headaches, some other forms are also noticed of primary headaches like primary exertional headache, hypnic headache, headache during sexual activity, cough headache, stabbing headache, thunderclap headache and NDPH.
Secondary Headache
Secondary headaches usually occur due to other obvious medical conditions including head or neck injuries and disorders of blood vessel, sinuses, nose, eyes, ears, skull, facial bones, mouth and teeth. Even intracranial and psychiatric disorders result in severe headaches.
Use or sudden withdrawal of medicines, drugs, caffeine or other chemical agents can result in headache. Infection and metabolic frenzies are obvious reasons for headache at times.
A patient’s medical history combined with CT scans, MRI, urine or blood tests can reveal the causes for a secondary headache.
Cranial Neuralgia and Central Causes of Facial Pain
An intense pain similar to electroshock in the innervated area of cranial nerve is known as cranial neuralgia. Various forms of cranial neuralgia include Trigeminal neuralgia, Occipital neuralgia and Gloss pharyngeal neuralgia. It also includes the headaches linked to Herpes zoster, cold stimulus and burning mouth syndrome.
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I am a bit surprised that the author did not reference the need to seek medical help in the event of a thunderclap headache. A thunderclap headache usually described as the “worst headache ever” is the primary presenting symptom of a ruptured cerebral Aneurysm, which is a genuine medical emergency.