Headache, or painful sensation in any region of the scalp, is a very common complaint. In fact we all experience it at some time or the other in life and for many people it is a regular occurrence. Despite this frequency, it is not completely understand as to why it occurs in every case. The pain in the head may be the only complaint at times while at other times a headache is accompanied by other symptoms such as dizziness, blurred vision and nausea.
Symptoms with a Headache
A headache is essentially pain in the head. It can vary in nature and intensity – dull, sharp, radiating, throbbing or pressure. Other symptoms may accompany a headache as follows:
- Nausea and vomiting may accompany a headache.
- A person with a headache may feel dizzy and unable to stand and remain stable.
- Nasal congestion may be present along with the headache.
- Eyes may also be affected. Watery eyes or eye pain is a common accompanying symptom.
- Pain in other areas of the head such as the jaw, nose or ear.
Read more on constant headaches.
Location of Head Pain
Headaches may either be felt over a wide area or a restricted to a specific area of the skull. When headaches affect the entire head, it may be difficult to pinpoint to arising from a specific point. This type of pain is known as a generalized headache. Even if one specific area of the head hurts more than the others, the headache is still referred to as a generalized headache. At other times, the headache may be restricted to a specific part of the skull and is referred to as a localized headache. These restricted locations are referred to as:
- Parietal: parietal refers to the flat bone that forms the topmost part of the skull. Parietal headaches affect the top (or vertex) of the head.
- Occipital: The occipital bones form the back of the skull. Therefore, occipital headache refers to pain in the back of the head.
- Temporal: Temporal bones form the sides of the skull. Temporal headache is pain that affects the areas above and around the ears.
- Frontal: The frontal bone forms the front part of the skull that lies above the eyes. Frontal headaches are quite common. Popular depictions of a headache usually involve a person massaging the frontal region of the skull with his or her fingers.
Pain may not be strictly localized within the boundaries represented by these anatomical terms. However, these are helpful terms to describe the approximate location of the pain.
Types of Headaches
Different types of headaches can occur in different locations. However, there is more to deciphering the cause of a headache than just its location. Therefore, the following descriptions of the locations of various types of headaches are not to be taken as diagnostic features.
The following are some of the types of headaches and their common locations:
The pain in a tension-type headache spans multiple areas of the skull, and is felt almost like a band around the head. The pain radiates from the back of the head (occipital region) to the front of the head (frontal region). Dull pain occurs on the top of the head (parietal region), where it seems as if pressure is being exerted on the vertex. Tension-type headache may also be accompanied by pain or stiffness in the neck region.
Cluster headache is usually unilateral, which means that the pain usually affects one side of the head. The most common painful area in cluster headache is the region around and behind the eye on the affected side of the face. Pain may also spread to the nose area (like the bridge of the nose or the whole nose area on the affected side).
Migraines can be either unilateral (mostly) or bilateral. The most common location of migraine pain is the frontotemporal region (the front and sides of the head). However, migraine can affect other regions, and the locations vary.
Ice pick headache
Ice pick headache has a tendency to cause pain on the sides (temporal) and top (parietal) of the head. However, the locations are not fixed and may affect other areas of the head. In fact, the location may vary during an attack.
Brain freeze (also known as cold-stimulus headache or ice-cream headache) is a bilateral pain that affects both the temporal regions of the head. In addition to the temporal region, the area around the eye (either on one side or on both sides) may also get painful.
Chronic paroxysmal hemicrania
Chronic paroxysmal hemicrania, as the name suggests, is a long-term paroxysmal pain that usually affects only one side of the head. The most painful areas are usually the temples and the periorbital area.
SUNCT is an acronym for Short-lasting, Unilateral, Neuralgiform headache attacks with Conjuctival injection and Tearing. The name is technically descriptive in terms of the nature and location of the pain. The major area of pain is around the eye region (periorbital).
Headaches associated with exertion
Headaches can also occur as a result of certain activities that require intense physical exertion, such as cough, exercise, and intercourse. The pain tends to be either generalized or localized to the occipital (back) and parietal (top) regions of the head.
Location of Headaches
As can be seen from the descriptions of various headaches, the location and pattern of headaches vary in different conditions. However, they cannot be taken as independent diagnostic criteria. This is because the different types of headaches may share the same locations. The classification of headaches based on the location (listed below) will make this apparent.
Read more on head pain.
Headache involving the top of the head
Tension-type headache, ice pick headache, headaches due to cough, exertion, and intercourse.
Headaches involving the back of the head
Tension-type headache, cervicogenic headache, and headache due to cough.
Headaches involving the sides of the head
Migraine, ice pick headache, brain freeze (cold-stimulus headache), and chronic paroxysmal hemicrania.
Headaches involving the front of the head
Tension-type headache, migraine, eye strain, and sinusitis.
Headaches involving the region around the eyes
Cluster headaches, chronic paroxysmal hemicrania, cold-stimulus headache, and SUNCT.
As can be seen from the regional classification of headaches, no clear diagnosis can be made based on just the location of the headache. A particular type of headache can affect multiple areas of the head, and a single area of the head may be involved in different types of headaches. A doctor will take into account other signs and symptoms that accompany a headache in order to arrive at a diagnosis and treatment regimen.