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Causes and Treatments of Migraine Headaches (cont.)

Secondary Headaches

Secondary headaches are related to physical problems and include the following:

  • Space-occupying intracranial (inside the head) lesions: The headaches associated with intracranial tumors are initially paroxysmal. Classic headaches of this type wake a person from sleep at night and are associated with projectile vomiting. With time, the headaches may become continuous and intensify with activities that increase intracranial pressure (for example, coughing, sneezing).
  • Meningeal irritation: Meningitis, especially the chronic forms (tuberculous, fungal), can irritate the meninges (membrane covering the brain and spinal cord) and result in chronic headaches. The headaches are often diffuse (spread out).
  • Posttraumatic headache: Headache can be part of a postconcussion syndrome. Patients may report vague headaches, fatigue, memory problems, and irritability for months or years after the traumatic event.
  • Temporal arteritis: This is an inflammation of some of the arteries of the extracranial (outside the skull) arteries. The headache is generally localized to the affected side and may be worsened by chewing.
  • Post-lumbar puncture (spinal tap) headache: Lumbar puncture can cause a headache that is worsened by sitting up from a lying position. It usually goes away by itself after the person drinks fluids and has caffeine in some form.
  • Referred pain: Headache may be a form of referred pain from neighboring structures. Dental disease can cause chronic headaches. Upper neck diseases or arthritis can also cause headaches. People with acute sinus or jaw problems can experience headaches; however, uncomplicated chronic sinusitis does not cause headaches.
  • Idiopathic intracranial hypertension (benign intracranial hypertension, pseudotumor cerebri): This disorder, most common in young women, is due to increased intracranial (within the head) pressure in the absence of any structural central nervous system abnormality or obstruction to the flow of cerebrospinal fluid.

Medically reviewed by Joseph Carcione, DO; American board of Psychiatry and Neurology

REFERENCES:

1. Diener HC, Limmroth V. Acute management of migraine: triptans and beyond. Curr Opin Neurol. Jun 1999;12(3):261-7. [Medline].
2. Fusco BM, Colantoni O, Giacovazzo M. Alteration of central excitation circuits in chronic headache and analgesic misuse. Headache. Sep 1997;37(8):486-91. [Medline].
3. Gunasekara NS, Noble S, Benfield P. Paroxetine. An update of its pharmacology and therapeutic use in depression and a review of its use in other disorders. Drugs. Jan 1998;55(1):85-120. [Medline].
4. Headache Classification Committee of the International Headache Society. Classification and diagnostic criteria for headache disorders, cranial neuralgias and facial pain. Cephalalgia. 1988;8 Suppl 7: 1-96. [Medline].
5. Kors EE, Haan J, Ferrari MD. Genetics of primary headaches. Curr Opin Neurol. Jun 1999;12(3):249-54. [Medline].
6. Mathew NT. Advances in cluster headache. Neurol Clin. Nov 1990;8(4):867-90. [Medline].
7. Mathew NT. Transformed migraine, analgesic rebound, and other chronic daily headaches. Neurol Clin. Feb 1997;15(1):167-186. [Medline].
8. Peroutka SJ. Dopamine and migraine. Neurology. Sep 1997;49(3):650-6. [Medline].


Medically Reviewed by a Doctor on 2/10/2016
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