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Headache Headache Basics

Headaches: When Should You Worry?


Author:

Richard Lappin, MD, PhD

New York Presbyterian Hospital - Weill Cornell Medical College

Medically Reviewed On: December 07, 2001

Introduction

Almost everyone gets a headache once in a while, and some unlucky people have them almost every day. Usually we pay little attention to them—we take a couple of Tylenol, and in a few hours the headache is gone. But sometimes headaches become so painful or so frequent that we start to worry: could it be the symptom of a brain tumor or the warning sign of an oncoming stroke?

The good news about headaches is that the vast majority of headaches are completely harmless. However, every once in a while a headache is a warning of some serious—or even deadly—condition. So how do you tell?
 

Old Versus New Headaches

There’s an old joke in which a worried patient asks, “Doc, what have I got?”
“Have you had it before?” the doctor asks.
“Yes,” the patient replies.
“Well,” the doctor announces, “you’ve got it again.”

There’s an important lesson in this joke; sometimes the most important fact about your symptom is whether it’s happened to you before. This is especially true with headaches.
 

Chronic Headaches

You might think that the longer you’ve been suffering from headaches, the more likely they are to be dangerous. In fact, the opposite is true—the longer you’ve been suffering from headaches, the less likely it is that they indicate some serious condition. As a rule, any sort of headache that you’ve had many times over a period of several years, without developing any other symptoms, is almost certain to be harmless. Doctors call these chronic headaches. The two most common types of chronic headache are tension-type headaches and migraines.
 

Tension Headaches

Tension-type headaches usually feel like a tight band around the head, or just an aching pain all over the head. The name tension suggests that these headaches are brought on by emotional tension, or that they are caused by some sort of tension in the muscles of the neck and head. In fact, it’s not clear how significant a role either type of  tension plays in these headaches. It’s certainly true that some people do get this sort of headache toward the end of a stressful day, and sitting or working in awkward positions can bring them on.
 

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