Almost everyone has had a headache at some time in their life. Most people describe a tension headache as a constant, dull achy feeling on both sides of the head. Another name for this type of headache is “stress headache.” Over-the-counter pain medication usually provides relief for tension headache sufferers.

About 12 percent of Americans suffer from migraine headaches. Migraine headaches can range from mild to severe on one or both sides of the head and are often associated with other symptoms. While migraine headaches can affect both young and old, studies have shown more women than men suffer from migraine attacks.

“The most common types are migraines and tension headaches. It is estimated 28 million people in the United States have migraine headaches,” said Dr. P.D. Patel, a neurologist and neuro-psychiatrist.

In the early 1990s, the International Headache Society developed a classification system doctors, like Patel, use today to differentiate the different types of headaches. Headaches are grouped into four main categories: Migraine, tension, cluster and miscellaneous.

Headaches account for 10 million visits to physicians’ office each year and rank among the most common local pain complaints. However, as common as headaches are, much about their condition remains a mystery. Researchers are not exactly sure what causes headaches or why some people are more susceptible than others. Some researchers believe that migraines occur in people who are predisposed to them and migraine headaches run in families.

Regardless, the number of cases of migraine headaches is on the rise. Based on statistics shared by Patel, one out of four people suffers from migraines. He estimated that at least four percent of the total number of patients who see their primary-care physician complain of a headache.

Reports of migraines in the United States have increased dramatically since 1980, when 25.8 people per 1,000 suffered from them. By 1989, the Center for Disease Control (CDC) reported, the number had risen to a record level of 41 people per 1,000. Most of the increase was in people less than 45 years old and the jump was greater among women.

Patel said women are twice as likely as men to suffer from migraine headaches. Approximately 17.6 percent of women and only 5.7 percent of men report having one or more migraine headaches a year.

Migraine headaches can be classified as either classic or common. A common migraine is when pain becomes more severe and throbbing, usually on one side of the head. About 20 percent of sufferers have what’s called a classic migraine.

Prior to the onset of a classic migraine, Patel said, the sufferer may experience a sleepy feeling, sometimes depression, followed by sensitivity to bright lights, odors or sounds. Classic migraines are distinguished by “an aura” — a peculiar sensation preceding the appearance of more definite symptoms. Patel said sufferers often complain of visual disturbances, such as “seeing stars before their eyes,” flashing lights, dots or floating images.

A classic migraine is characterized by severe, throbbing, unilateral pain. Symptoms can last for a few minutes to several hours or, in some cases, days. The frequency of occurrence can vary as well. Some sufferers experience multiple classic migraine headaches per month. Other features of the classic migraine aura include nausea and vomiting.

The pain from both classic and common migraines is usually in the front of the head, in the eye or temple region.

Doctors will prescribe medication to try to prevent the onset of a migraine and to lessen the frequency of migraine headaches.

Unlike migraines, cluster headaches mainly affect men. These excruciating, painful headaches occur in bursts and are felt primarily behind the eyes or in the temples.

Patel said cluster headaches are often associated with the weather. If you have a cluster headache at 2 a.m., he said, the pain will likely reoccur at exactly the same hour the following morning. Attacks can last from 45 minutes to two hours and tend to occur at night.

The neurologist has some of his patients keep “a headache diary” to help determine what factors trigger migraines. Patients include entries on the day and hour of their headaches, symptoms, precipitating and aggravating factors.

Headaches with specific symptoms may warrant urgent medical attention, particularly sudden, severe headaches accompanied with a stiff neck or headaches followed by a fever.

“If you have the worst headache of your life, or a headache with a fever, go immediately to the emergency room,” Patel said. n

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