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Headache Symptoms and Diagnosis

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Headache symptoms vary depending on what is causing the pain. Primary headache syndromes include migraines, tension-type headaches, and "trigeminal autonomic cephalalgias" (such as cluster headaches). Headache pain may be triggered by certain foods, medications, dehydration, weather changes, or changing levels of hormones.

NewYork-Presbyterian's headache specialists have exceptional expertise treating all types of headache disorders. Some of the most common types include:

  • Migraine, which presents as throbbing pain on one or both sides of the head of moderate to severe intensity and which can feel worse upon exertion. Migraine headaches may also be accompanied by nausea or vomiting and sensitivity to light, sounds, smells, and movement.
  • Tension-type headaches, which manifest as dull pain or a feeling of tightness on both sides of the head. Pain may be mild to moderate, but is usually not severe and not associated with sensitivity to sensory stimuli (such as light, smell, or sound).
  • Trigeminal autonomic cephalalgias (TACs), characterized by recurrent episodes of moderate to severe pain on one side of the head or face. Patients may also experience eye tearing, swelling or drooping of the eye, eye redness, and/or nasal congestion or drainage on the same side of the pain. Cluster headache is the most common headache disorder within this group, with pain typically centered behind one eye. Cluster headaches usually occur in a series that may last weeks or months in a row, and then recur every year or two.

Frequent use of pain medications (over-the-counter or prescription drugs) can also lead to headaches; this is called a medication-overuse or "rebound" headache, and can be challenging to treat. Patients with headache symptoms that don't get better with over-the-counter medications should see a doctor to prevent medication-overuse headache.

"Secondary" headaches are symptoms of another medical problem, such as an aneurysm or brain tumor. Headaches that are extremely severe ("worst headache ever") or cause vision changes, weakness of the arms or legs, or seizures may be caused by an aneurysm and require emergency attention. Patients with secondary headaches who come to NewYork-Presbyterian Hospital will be referred for appropriate care by our specialized physicians.

NewYork-Presbyterian specialists diagnose a headache condition using a comprehensive medical evaluation (including thorough questioning of the patient about headache frequency, symptoms, and possible triggers), neuropsychological assessment, and diagnostic testing. Tests used to determine the cause of a headache may include:

  • Blood tests
  • Magnetic resonance imaging
  • Computed tomography scanning
  • Spinal fluid analysis

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