Headaches can have many different causes. They are generally classified into primary headaches like tension headaches and migraines, which are benign and self-limiting, and secondary headaches caused by underlying conditions like meningitis, brain tumors, or head injuries. The brain itself is not sensitive to pain, but structures like the blood vessels, dura, and sinuses surrounding it can stimulate pain fibers when tugged, stretched, or inflamed. Different areas of stimulation lead to pain being referred to specific parts of the head. Common primary headaches include tension, migraine, and sinus headaches.

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2. Headache (Cephalgia)
• Is a condition of pain in the head; neck or
upper back pain may also be interpreted
as a headache.
• Headaches are a type of pain referred to
the surface of the head from deep head
structures.
• Some headaches result from pain stimuli
arising inside the cranium, but others result
from pain arising outside the cranium, such
as from the nasal sinuses.
• It ranks amongst the most common local
pain complaints.
• majority of headaches are benign and self-
limiting.

3. Common causes are
• Tension,
• Migraine,
• Eye strain,
• Dehydration
• and sinusitis.
• Much rarer are headaches due to life-threatening
conditions such as
• Meningitis,
• Encephalitis,
• Cerebral aneurysms,
• and brain tumors.
• When the headache occurs in conjunction with a
head injury the cause is usually quite evident.

4. Pain-Sensitive Areas in Cranial Vault.
• The brain tissues themselves are almost totally
insensitive to pain. Even cutting or electrically
stimulating
• Tugging on the venous sinuses around the
brain, or stretching the dura at the base of the
brain can cause intense pain that is recognized
as headache.
• Also any type of traumatizing, crushing, or
stretching stimulus to the blood vessels of the
meninges can cause headache.
• Especially sensitive structure is the middle
meningeal artery,

5. Areas of Referred Headache
• Stimulation of pain receptors in
the cerebral vault above the
tentorium, including the upper
surface of the tentorium itself,
initiates pain impulses in the
fifth nerve and, causes
referred headache to the front
half of the head in the surface
areas supplied by this
• pain impulses from beneath
the tentorium enter the central
nervous system through the
glossopharyngeal, vagal, and
second cervical nerves, which
also supply the scalp above,
behind, and slightly below the
ear.
• Subtentorial pain stimuli cause
"occipital headache" referred
to the posterior part of the
head

7. • Types
• There are five types of headache:
• vascular,
• Myogenic (muscle tension),
• Cervicogenic,
• Traction,
• Inflammatory.
• Muscular/myogenic headaches appear to
involve the tightening or tensing of facial and
neck muscles; they may radiate to the
forehead.
• Tension headache is the most common form of
myogenic headache.

8. •
Vascular
1. The most common type of vascular
headache is migraine.
2. After migraine, the most common type
of vascular headache is the "toxic"
headache produced by fever.
3. headaches resulting from high blood
pressure (rare).

9. Cervicogenic headaches
• Originate from disorders of the neck,
including the anatomical structures
innervated by the cervical roots C1–C3.
• Cervical headache is often precipitated
by neck movement and/or sustained
awkward head positioning.

10. • Specific types of headaches include:
• Tension headache
• Migraine
• "Brain freeze" (also known as: ice cream headache)
• Thunderclap headache
• Toxic headache
• Coital cephalalgia (also known as: sex headache)
• Sinus headache
• Rebound headache (also called medication overuse
headache, abbreviated MOH)
• Red Wine Headache
• Like other types of pain, headaches can serve as
warning signals of more serious disorders. This is
particularly true for headaches caused by
inflammation, including those related to meningitis

11. What is a migraine headache?
• A migraine headache is a severe pain felt on one,
and sometimes, both sides of the head. The pain is
mostly in the front around the temples or behind one
eye or ear. Besides pain, there is nausea and
vomiting, and be very sensitive to light and sound.
• Migraine can occur any time of the day, though it
often starts in the morning. The pain can last a few
hours or up to one or two days.
• Causes of migraine headaches, are not known but
some things are more common in people who have
them.
• ages of 15 and 55.
• family history of migraine.
• They are more common in women.

12. causes migraine?
• One cause of migraine is the blood flow theory.
• Blood vessels either narrow or expand.
• Narrowing can constrict blood flow, causing problems with sight or
dizziness.
• When the blood vessels expand, they press on nerves nearby, which
causes pain.
• Another theory focuses on chemical changes in the brain. When
chemicals in the brain that send messages from one cell to another,
including the messages to blood vessels to get narrow or expand, are
interrupted, migraines can occur.
• Most migraines are not caused by a single factor or event.
• Many women with migraine tend to have attacks brought on by:
• lack of food or sleep
• bright light or loud noise
• hormone changes during the menstrual cycle
• stress and anxiety
• weather changes
• chocolate, alcohol, or nicotine

13. Classic Migraine
• With a classic migraine, a person has these visual
symptoms (also called an “aura”) 10 to 30 minutes
before an attack:
• sees flashing lights or zigzag lines
• has blind spots or loses vision for a short time
• The aura can include seeing or hearing strange things. It
can even disturb the senses of smell, taste, or touch.
Women have this form of migraine less often than men.
• Common migraine. With a common migraine, a person
does not have an aura, but does have the other migraine
symptoms, such as nausea and vomiting

14. Menstrual cycle & migraine
• More than half of women with migraine have
more headaches around or during their
menstrual cycle. This is often called “menstrual
migraine.
• Just before the cycle begins, levels of the female
hormones, estrogen and progesterone, sharply
go down. This drop in hormones may trigger a
migraine, because estrogen controls chemicals
in the brain that affect a woman’s pain
sensation.

15. Headache of Meningitis.
• Most severe headaches of all is that
resulting from meningitis, which causes
inflammation of all the meninges, including
the sensitive areas of the dura and the
sensitive areas around the venous
sinuses. Such intense damage can cause
extreme headache pain referred over the
entire head.

16. Headache Caused by Low Cerebrospinal
Fluid Pressure.
• Removing as little as 20 milliliters of fluid
from the spinal canal, causes intense
intracranial headache.

17. Alcoholic Headache.
• As many people have experienced, a
headache usually follows an alcoholic
binge. It is most likely that alcohol,
because it is toxic to tissues, directly
irritates the meninges and causes the
intracranial pain.

18. Headache Caused by Constipation.
• Constipation causes headache in many
people. result from absorbed toxic
products

19. Extracranial Types of Headache
• Headache Resulting from Muscle
Spasm. Emotional tension often causes
many of the muscles of the head, spastic,
and is one of the common causes of
headache.

20. Headache Caused by Eye Disorders.
• Difficulty in focusing one's eyes clearly may
cause excessive contraction of the eye ciliary
muscles in an attempt to gain clear vision. cause
retro-orbital headache.
• when the eyes are exposed to excessive
irradiation by light rays, especially ultraviolet
light. Looking at the sun or the arc of an arc-
welder for even a few seconds may result in
headache that lasts from 24 to 48 hours.

21. Sinus headache
• There are several paired paranasal sinuses,
including the frontal, ethmoid, maxillary and
sphenoid sinuses.

22. • Maxillary sinusitis
• cause pain or pressure in the maxillary
(cheek) area (e.g., toothache, headache)

23. • Frontal sinusitis - can cause pain or
pressure in the frontal sinus cavity
(located behind/above eyes), headache

24. Ethmoid sinusitis
• can cause pain or pressure pain between
and/or behind eyes, headache

25. Sphenoid sinusitis
• - can cause pain or pressure behind the
eyes, but often refers to the vertex of the
head.

26. Tension headaches
• Renamed tension-type headaches by the
International Headache Society in 1988, are
the most common type of primary
headaches.
• The pain can radiate from the neck, back,
eyes, or other muscle groups in the body.
• Tension-type headaches account for nearly
90% of all headaches.
• Approximately 3% of population suffers
from chronic-tension type headache.

27. Frequency and duration
• Tension-type headaches can be episodic or
chronic.
• Episodic tension-type headaches are defined as
tension-type headaches occurring less than 15
days a month, whereas chronic tension
headaches occur 15 days or more a month for at
least 6 months.
• Tension-type headaches can last from minutes
to days or even months, though a typical tension
headache lasts 4-6 hours.

28. Cause and pathophysiology
• The exact cause of tension-type headaches is still
unknown.
• It is suggested that abnormalities in the peripheral and
central nervous systems may be involved in the
pathophysiology of TTH.
• It has long been believed that they are caused by muscle
tension around the head and neck and the restriction of
blood flow to those areas as a result, the cause of which is
in often the presence of an unresolved subconscious
emotional conflict and anxiety.
• One of the theories says that the main cause for tension
type headaches is teeth clenching which causes a chronic
contraction of the temporalis muscle.

29. Pain and possible symptoms
• Tension-type headache pain is often
described as a constant pressure,
• The pain is frequently bilateral which
means it is present on both sides of the
head at once. Tension-type headache
pain is typically mild to moderate, but may
be severe. In contrast to migrain the pain
does not increase during exercise.

30. • Another theory is that the pain may be caused by a
malfunctioning pain filter which is located in the brain
stem.
• The view is that the brain misinterprets information, for
example from the temporal muscle or other muscles,
and interprets this signal as pain.
• One of the main molecules which is probably involved is
serotonin.
• Evidence for this theory comes from the fact that chronic
tension-type headaches may be successfully treated
with certain antidepressants such as amitriptyline.

31. Toxic headache
• A toxic headache is the least common type
of vascular headache that usually comes
from a fever from acute illnesses such as
measles, mumps, pneumonia and tonsillitis.
• Common hazards in our environment also
cause toxic headaches with exposure.
• These include chemicals, fumes, pollution,
allergens and other health hazards.
• A chemical factor from the outside or inside
of body can result in a toxic headache.