Other types of headache
Tension type headache
A tension type headache tends to be a dull background ache. Patients often say it feels like a tight band across the forehead or a tight sensation coming up the back of the neck. It does not tend to have the other typical migraine features such as throbbing quality and aversion to bright lights or loud noises. It is really quite a feature-less headache.
A cluster headache presents as an acute sharp pain that occurs in episodes. It tends to occur above one eye or temple area. Sometimes it occurs on alternate sides. The pain is intense and lasts from about 20 minutes to a few hours. It tends to occur in bouts- such that you may experience this pain several times per day for a period of a few weeks and then it may go away for months or even years. Alcohol is a well-known trigger of cluster headaches and it also more commonly occurs in smokers. There is no one diagnostic test to establish that your headaches are cluster headaches- it requires a detailed history and examination. One of the most effective treatments is actually oxygen but there are medications that can be used in an effort to prevent the cluster headaches from occurring.
Headache relating to high or low pressure
His type of headache is uncommon. When it is caused by high pressure the headache gets worse on lying down. There can occasionally be other signs of a high pressure headache such as double vision or associated nausea and vomiting. This type of headache requires careful evaluation and you may need to have an MRI scan and possibly a lumbar puncture but this will be explained to you by your neurologist. A headache caused by low pressure gets worse on standing up. Again, this is an infrequent cause of headache.
Patients with migraine will often be referred to see an ENT specialist before seeing a neurologist. This situation arises because the pain is present in the face or sinuses and has the character of a “sinus pressure”. This is actually a common symptom of migraine. In the absence of fever, pus from your nose and alteration in smell your sinus pain is most likely to be migraine.