The most common types of headaches

  Headache is a very common clinical condition and almost all people experience headache in their lifetime.  Tension-type headache, the most common type of headache, has a prevalence of 38% and a lifetime prevalence of 46%, accounting for 70-80% of headache sufferers. In about half of patients, headache attacks interfere with daily activities.  The ratio of male to female prevalence is about 4:5. The peak age of onset is 25-30 years old, and the peak age of onset is 30-39 years old, which decreases slightly with age. The pain is usually bilateral, with the occipital, temporal or frontal regions being the most common, and often the entire top of the head. The pain sensation is mostly pressure, tightness, distension, feeling of explosion, dull pain, soreness, etc., which can be aggravated in bursts, without continuous pulsating sensation, nausea (chronic tension-type headache can have mild nausea), vomiting, not accompanied by photophobia and sound terror at the same time, and daily physical activities do not lead to aggravation of pain, which is often aggravated by stress and mental tension. The pain is mostly mild to moderate and does not interfere with daily activities. The onset of the disease is progressive, lasting a few days or weeks, months, or even years.  Psychological factors may lead to a vicious cycle. That is, patients with tension-type headache are prone to mental disorders such as depression or anxiety, which in turn promote the onset of tension-type headache. Tension-type headache is associated with depression and anxiety disorders; among them, generalized anxiety disorder and poor mood are the most common; chronic tension-type headache patients are more likely to have psychiatric disorders. Identifying these concomitant disorders can help in the treatment of tension-type headache and improve the quality of life of patients. Genetic factors may also play a role Influencing factors for poor prognosis are comorbid migraine, unmarriedness, sleep disorders, and fixed lifestyle.  Migraine, often referred to as vascular headache, is a common headache with a prevalence of 10% and a lifetime prevalence of 14%. It is a recurrent, often throbbing headache, mostly unilateral, often accompanied by nausea and vomiting, photophobia and vocal terror. The headache is exacerbated by regular physical activity (e.g., walking or walking upstairs) or the headache causes the patient to avoid regular physical activity. A few typical attacks are preceded by visual, sensory and motor aura and may have a family history. In adults, the ratio of male to female prevalence is between 1:2 and 1:3. In children before puberty, there is no gender difference in prevalence. The prevalence of migraine increases with age, reaching a peak at the age of 40 to 50 years, and decreases thereafter. The tendency for the prevalence to increase and decrease with age is more pronounced in women than in men. The onset of migraine is usually between the ages of 10 and 30. Risk factors for the disease include family history, low educational level, and high workload.  Migraine is a polygenic, multifactorial disease in which multiple environmental and genetic factors interact. Genetic, dietary, endocrine and psychological factors are related to the development of migraine. Migraineurs are more likely than the general population to have depressive disorders, anxiety disorders, lower back pain and other disorders. Migraines often have significant family aggregation. About 50% to 80% of patients have a positive family history.  Migraine attacks are often triggered, with some studies showing that 85% of patients complain of triggers, and often have multiple triggers. Common triggers include: weather changes, stress, depression, anxiety, painful crying, hunger, sleep disturbances, overwork, light stimulation, noise, strong odors, and diet. Common dietary triggers include: alcohol (especially red wine, which contains tyramine, sulfites, histamine, flavonoids, etc.), chocolate (containing phenylethylamine, caffeine), tyramine-containing foods (mature cheeses, cured products, smoked products, fermented foods, etc.), caffeine-containing diets (coffee, tea, carbonated beverages, chocolate), MSG (monosodium glutamate), saccharin (aspartic acid phenylalanine methyl ester), foods containing nitrites and nitrates (pickled products, smoked products, kimchi, coloring agents, preservatives, etc.), citrus fruits (containing tyramine, including orange, mandarin, orange, grapefruit, lemon, hedgehog, etc.), etc. In addition, the disease is more common in women, often beginning in adolescence, attacks mostly in the premenstrual or menstrual period, and gradually reduce or disappear after menopause. About 60% of female patients in their reproductive years stop having migraine attacks during pregnancy, and the attacks may recur after delivery.