Types of headache
Headaches are classified as primary, when the headache is the disorder itself, and secondary, when it is a symptom of another condition.
- Migraine: often throbbing pain of moderate or severe intensity, which worsens with physical activity and is accompanied by nausea and sensitivity to light and noise. In some people it is preceded by an aura, for example transient visual disturbances.
- Tension-type headache: band-like or cap-like pain of mild or moderate intensity, often related to stress, posture and lack of rest.
- Cluster headache: short, very intense attacks around one eye, with tearing and nasal congestion, recurring in periods.
- Medication-overuse headache: a headache that becomes almost daily because of too frequent use of painkillers.
When to see a neurologist
A neurological visit is useful when headaches are frequent, limit daily activities, change their usual features or no longer respond to the usual medicines.
A sudden, extremely violent headache should instead be assessed urgently in the Emergency Department, as should a headache with fever and neck stiffness, weakness, difficulty speaking, confusion or loss of consciousness, or one that starts after a head injury.
How the diagnosis is made
The diagnosis of primary headaches is mainly clinical: it is based on a careful interview and neurological examination. A headache diary, recording days, duration, intensity and medicines taken, helps a great deal in recognising the type of headache and its triggers.
Tests such as brain MRI are needed in selected cases, when the features of the pain or the neurological examination suggest a secondary cause. Thanks to his dual training in Neurology and Diagnostic Radiology, Dr. Bonacchi can also directly review images already performed.
Treatment
Treatment works on two levels: acute treatment, to relieve pain when it occurs, and preventive treatment, which reduces the frequency and intensity of attacks. For migraine, new-generation specific drugs are now also available, indicated in more frequent or resistant cases.
Lifestyle habits are just as important: regular sleep, regular meals, physical activity and correct use of painkillers.
Neurological visit in Milan, Osio Sotto (Bergamo) and Pistoia
Dr. Raffaello Bonacchi, neurologist and neuroradiologist, sees patients in Milan, Osio Sotto (Bergamo) and Pistoia, and also offers online consultations with review of tests and images already performed.
Frequently asked questions
Are frequent headaches dangerous?
In most cases no: they are benign primary headaches, which can however greatly affect quality of life and deserve proper treatment. Some warning signs, on the other hand, require urgent assessment.
Is an MRI always needed?
No. The diagnosis of primary headaches is clinical. MRI is indicated only in selected cases, as assessed by the neurologist.
The information on this page is for general information only and does not replace a medical visit. For sudden or severe symptoms call 112 or go to the Emergency Department.