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Headache Headache Basics

Headaches: When Should You Worry?


Richard Lappin, MD, PhD

New York Presbyterian Hospital - Weill Cornell Medical College

Medically Reviewed On: October 27, 2013

Migraine Headaches

Migraine headaches are slightly different. The pain of migraine is usually a pounding rather than tight feeling. Instead of being all over the head, migraine pain is usually much worse on one side, and often seems to be centered around or behind one eye. For this reason, many people with migraine mistakenly attribute their headaches to eye strain or sinus trouble. Many people feel nauseated during a migraine, and because light and sound become painful, they want to lie down in a dark, quiet room until the headache passes.  Some people see shimmering zig-zags of light and color move across their field of vision several minutes before their headache starts, something referred to as an aura.

Even though migraine is very common, we still don’t understand why some people are cursed with it, or exactly what goes on inside the head to cause the headache. Some people will have one or two migraine headaches in a lifetime, while others have them almost daily. Migraine headaches can be excruciating, and frequent migraines can completely disrupt a person’s daily life. The treatment of migraine is too complicated a subject to discuss here, but there are ways both to prevent migraine headaches, and to relieve them when they do happen.

When to Worry

Since chronic headaches are almost never anything to worry about, when should you worry? As a general rule, doctors are most concerned about new headaches. If you suffer from occasional headaches, a new headache means a headache that feels different from any you’ve had before. If you never get headaches, any headache is new. Are all new headaches dangerous? No. The great majority of new headaches turn out to be harmless, too. Many turn out to be migraine or tension-type headaches—after all, everyone with chronic migraines must have had a first, new headache at the beginning. But if you are having new headaches, you should have them evaluated by a physician.

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