Almost all people experience headaches of varying degrees during their lifetime. Most headaches are functional, but sometimes they are an early symptom of some serious organic disease.
Classification of headaches and common disorders
Acute and slow onset of headache
Acute onset of headache with fever: Commonly associated with epiglottitis, influenza, etc. If there is no fever but vomiting and impaired consciousness, there is often a possibility of intracranial hemorrhage.
Slow onset headache: Commonly caused by hypertension, cerebral blood supply deficiency, intracranial tumor, vascular neurological headache, chronic rhinitis and sinusitis, etc.
Site of headache
Pain located in the upper part of the orbit or around the eye is commonly associated with glaucoma.
Pain located in the forehead and on both sides of the nose and cheeks, mostly due to sinusitis.
Headache located on one side, usually migraine and trigeminal neuralgia.
Full headache, commonly seen in various kinds of encephalitis or meningitis.
Hard neck and severe headache with fever and vomiting are commonly seen in rhinencephalitis.
Occurrence and duration of headache
Regular morning boring headache is seen in sinusitis.
Headache with slow onset and frequent morning exacerbation is commonly seen in intracranial tumors
Severe pain that lasts only tens of seconds, most often seen in trigeminal neuralgia
Recurrent headache that lasts for several hours or 1 to 2 days, mostly seen in migraine.
Headaches that are prolonged and have significant susceptibility to change are mostly neurological headaches.
Degree of headache
Severe headache, commonly seen in trigeminal neuralgia, migraine and meningitis.
Moderate or milder headaches, commonly due to lesions of the eyes, nose, teeth and brain tumors.
Nature of headache
Paroxysmal electric shock-like short, severe pain in the face, mostly seen in trigeminal neuralgia.
Pulsating headache or throbbing pain, commonly seen in hypertension, vasoneurotic headache, acute febrile diseases and brain tumors.
Accompanying symptoms of headache
Headache with severe vomiting is common in cerebrovascular disease, brain tumor, encephalitis and meningitis, etc.
Vomiting when the headache reaches its peak and the headache is obviously relieved after vomiting is common in vascular neuropathic headache.
Headache with severe vertigo is commonly caused by brain tumor and insufficient blood supply to vertebrobasilar artery.
Chronic headache with mental dullness, indifferent expression, indifference to surrounding things or, on the contrary, euphoria is common in brain tumors and sporadic encephalitis.
Headache with visual impairment is commonly associated with glaucoma and brain tumor.
Headaches preceded by flashes of light, dark spots or hemianopia are commonly associated with vasoneurotic headaches.
Factors triggering headache
Headaches caused by changes in the horizontal position of the head are commonly caused by cervical spondylosis.
Headache aggravated by head turning, head bending, or coughing is commonly caused by brain tumor or meningitis.
What to do if you have a headache
If you have a persistent headache, you should go to the hospital promptly.
Headaches caused by head trauma should be seen in neurosurgery regardless of whether there is bleeding or not.
Sudden onset of severe headache accompanied by vomiting, impaired consciousness or hemiplegia should be seen by neurology.
Recurrent chronic headache with or without aura; lasting for seconds to tens of hours should also be seen in neurology.
Patients with chronic headache should also be seen in neurology.
Patients with pain around the eye and above the orbit with visual disturbance should be referred to ophthalmology; those without visual disturbance should be referred to neurology.
Patients with pain in the forehead and cheeks, purulent nasal discharge, or pain on the temporal side, ear discharge and hearing loss should consult otolaryngology.
Headache is often closely related to horizontal head rotation, and those with dizziness and arm numbness should be referred to neurology or orthopedics.
Children under 14 years of age with headache should be seen in pediatrics.