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Causes of other primary headaches
Other types of primary headache include:
"Ice cream" headache. The International Headache Society criteria define this headache as pain that develops during the ingestion of cold food or drink that lasts for less than five minutes and is felt in the middle of the forehead. The headache is prevented by avoiding rapid swallowing of cold food and drink. This type of headache occurs more frequently in patients who have migraine, but it can also occur in migraine-free patients. It has been suggested that the pain is referred from the palate or teeth via the trigeminal nerve. The pain is self-limited and only rarely requires treatment.
Cough headache. Cough headache is considered by some to be a form of exertional headache and is sometimes grouped together with other headaches described as "sneezing headache" and "laughing headache." The International Headache Society defines cough headache as a headache that is felt in both sides of the head, that is of sudden onset, that lasts less than one minute, is brought on by coughing, and can be prevented by avoiding coughing.
Ice pick headache. This type of headache pain is described as momentary, sharp, or jabbing and occurring either once or several times a day at irregular intervals. It has also been nicknamed the "jabs and jolts" or "stabs and jabs" headache. The pain is most often felt around one eye or the temple area, and it recurs in the same place or may move to other places on the same side of the head or the opposite side. These headaches are more likely in patients with migraine or cluster headaches. It is uncommon in the pediatric and adolescent population. This type of headache disappears spontaneously in many cases or can be successfully treated with indomethacin.
Altitude headache. This headache is especially common in individuals who climb mountains and ski at high altitudes. It may be seen in acute mountain sickness along with other primary symptoms of pulmonary edema and cerebral edema. The headache is experienced at high altitudes (above 8,000 feet and with increasing frequency as elevation increases) and is usually associated with low oxygen levels. The headache is described as generalized and throbbing and is aggravated by exertion, coughing, and lying down. The headache usually appears from six to 96 hours after arriving at high altitudes. Relief of headache is obtained by descending to lower altitudes; oxygen inhalation and medications also work.
Chronic paroxysmal hemicrania. Also called "atypical cluster headache," this type is identified by the occurrence of multiple daily attacks--usually five per day--that last from five to 30 minutes apiece. The pain, typically severe, usually occurs on one side of the head and rarely alternate sides. Other symptoms (including eye tearing, eye redness, eyelid edema, nasal congestion, and runny nose) may be present. The pain is most frequently localized to the eye or forehead above the eye on one side of the head. The disorder responds dramatically to indomethacin, a nonsteroidal anti-inflammatory drug. When indomethacin is discontinued, the headaches reappear in several days.
Hemicrania continua. This steady, moderately intense headache is characterized by episodes of more intense pain that occur several times a day. The pain is localized to the front part of one side of the head and is not associated with nausea, although it may be accompanied by symptoms such as eye tearing, eye redness, eyelid edema, nasal congestion, and runny nose. The headache is not brought on by any particular event and the cause is not clear. Most people affected are female. Headaches typically begin during adolescence, and there is usually no family history of headache. Indomethacin is the treatment option of choice.
Occipital neuralgia. Pain is experienced at the back of the head, often starting at the upper neck or base of the skull. It may occur on one or both sides of the head and can be infrequent, can occur several times per day, or can be constant. The pain is described as jabbing or throbbing, and may radiate to the front of the head or to the eye. At times, pain can be brought on by movement, especially an overextension of the head. Other symptoms may include dizziness and, rarely, nausea and vomiting. In addition, patients report that their scalp is sensitive to the touch. Occipital neuralgia is often seen in athletes--particularly weightlifters, wrestlers, and football players--and others, such as persons involved in automobile accidents and those who incur extension and flexion injuries. Physical examination may reveal cervical area tenderness, range-of-motion limitation, and decreased sensation at the back of the head. Treatment may include use of a soft cervical collar, analgesics, muscle relaxants, local injections, and, on rare occasions, surgery.
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