Thursday, June 23, 2011

Types of Headaches

Types of Headaches

There are two types of headaches: primary and secondary. Primary headaches are ascribed to a neurological disorder. For instance, headaches associated with tension and migraine. These two primary headaches are generally misdiagnosed as sinus headache, making epidemiology of sinus headache complex.

Many common symptoms of sinus headache and a primary headache make it difficult to distinguish between the two. However, sinus headache has the following unique symptoms:

  • Continuous nasal congestion or obstruction that is not because of phonophobia, photophobia, auras, vomiting or nausea associated with migraine.
  • Dull pressure-like pain, which is generally periorbital. The pain worsens in the morning, thereafter it improves.
  • Pain concentrates over the infected sinus during Mueller sign test.


Sinus headache, the most common form of secondary headache, is mainly caused by acute rhino sinusitis. As per International Classification of Headache Disorder (ICHD)-II symptoms of the headaches ascribed to rhino sinusitis include:

  • As soon as acute exacerbation of the disease starts, facial pain and headache begins.
  • Evidence of acute-on-chronic or acute rhino sinusitis is found in magnetic resonance, nasal endoscopic, clinical and Computed Tomography (CT) images.
  • Facial pain or headache disappears within a week after curing acute-on-chronic or acute rhino sinusitis.
  • Pain in teeth, ears or face and frontal headache


Sinus Headache vs. Migraine

  • An acute headache or an acute exacerbation indicates sinus headache, whereas recurrent headaches are symptom of migraine.


  • Self-limited headaches of short duration accompanied by nasal discharge are a sign of migraine.
  • Migraine is aggravated by bright light or noise unlike sinus headaches.


  • Sinus headache creates dull deep achy feeling, fullness and heaviness. Pain increases while lying down and bending forward. Nasal discharge may have blood or be of yellow-green color.
  • Doctors may conduct the following tests to find out whether you are suffering from sinusitis or not:


    • Imaging tests include MRI or CT scans. MRI uses radio waves and magnetic field to generate cross sectional pictures of the brain. CT produces images of the brain and sinuses with the help of a computer. CT captures details, like level of air-fluid, clouding, scarring, swelling of sinus surface, on the images.
    • During mucus testing, a sample of mucus from nose is examined to check for fungal or bacterial infection.


    • Nasal endoscopy uses an endoscope (a thin tube with a light) for examining nasal passages. With the endoscope, doctors can visualize condition of the nasal passages and nose, and confirm or rule out presence of infection.

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