I often encounter patients who ask me, “Dr. Wang, I have had headache for many years, some hospitals say I have vascular headache, some say I have vascular-neural headache, some say I have migraine, which kind of headache do I have?” In fact, both “vascular headache”, “neurogenic headache” and “vascular-neurogenic headache” are all terms that arose under the old headache classification method in the past. With the gradual research in the field of headache, it has been found that the causes of headache are very complex, and the Western medical pathogenesis of many headaches is still inconclusive, so it is difficult to separate them absolutely by such terms as “vascular” or “neurological”. In the 1940s, for example, the pathogenesis was thought to be primarily neurological, and the “neurogenic theory” suggested that brain dysfunction in migraineurs began in the occipital lobe and spread throughout the head, explaining the visual aura and headache of migraine. In the 1960s, some scholars proposed that migraine was caused by the first appearance of intracranial blood vessels (such as constriction of the ophthalmic artery causing visual aura like migraines and flashes of light), followed by the violent expansion of extracranial blood vessels and headache attacks, and the “vascular origin theory” came into being. In the 1980s, the “neurogenic inflammatory response theory” emerged. This theory suggests that migraine is caused by the stimulation of the trigeminal nerve by an unexplained stimulus, which causes the release of chemical substances such as substance P, calcitonin gene-related peptide and neurokinin from the trigeminal nerve endings, resulting in local inflammatory response and vasodilation and stimulating headache. With the gradual advancement of research in medical science, the “combined vascular-neural theory” has been recognized by most medical experts in recent years. This theory suggests that migraine is based on a combined brainstem, trigeminal-vascular reflex. Various stimuli can affect the cortex, thalamus and hypothalamus, and then stimulate the brainstem, leading to changes in cortical function, aura symptoms, and then vasodilatation, which stimulates the trigeminal nerve and causes local inflammation at the nerve end; on the other hand, it prompts the release of 5-HT from platelets, which decreases the concentration of 5-HT and weakens the anti-pain effect, leading to an increase in headache. In addition to the above-mentioned main views, in the field of research on the pathogenesis of migraine, various theories including genetic predisposition, low magnesium theory, high potassium theory, calcium channelopathy (increased intracellular calcium), mitochondrial dysfunction (energy metabolism), nitric oxide hypothesis, platelet activity, release response, structural abnormalities, etc. have emerged. However, to date, the Western pathogenesis of migraine has not been conclusively established. In order to standardize the treatment in the field of headache, the International Headache Society has launched the second edition of the International Classification of Headache Disorders, which divides headache disorders into 3 major parts and subdivides them into 14 types. Part I: Primary headache includes: 1. migraine 2. tension-type headache 3. cluster headache and other trigeminal phytogenic headache 4. other primary headache Part II: Secondary headache includes: 5. headache due to head and neck trauma 6. headache due to head and neck vascular disease 7. headache due to non-vascular intracranial disease 8. headache due to a substance or substance withdrawal 9. headache due to infection 10. Headache due to infection 10. Headache due to metabolic disorders 11. Headache due to lesions of the head, neck, eyes, ears, nose, sinuses, teeth, mouth, or other head and facial structures 12. Headache due to psychiatric disorders Part III: Cranial neuralgia, central and primary facial pain, and other headaches include: 13. The International Headache Society (IHS) has recommended that headaches be treated worldwide. Accordingly, the International Headache Society recommends that the use of terminology be standardized worldwide in all clinical and scientific fields related to headache. The terms “vascular headache” and “neuropathic headache” will be gradually withdrawn from the diagnostic system of headache and replaced by new classifications and diagnostic terms.