Check Your Work: Understanding Headache Types

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Dive in and learn more about the answers to yesterday’s quiz.

Before you read further, take the quiz: Quiz: Understanding Headache Types

Each week during Migraine and Headache Awareness Month, Drug Topics will be publishing a weekly quiz focused on a different aspect of allergy and asthma management. Our first weekly quiz, published on Thursday, June 6, focused on understanding the different types of headaches. Below, we break down the answers.

Question 1

Tension-type headaches are one of the most common types of headache. These headaches are characterized by:

Answer: A dull, aching sensation around the head

Tension-type headaches, estimated to impact 2 in 3 US adults, frequently present with pain described as “a tight band around the forehead” or a dull but steady ache on both sides of the head. The root cause of these headaches is unknown, but some research has suggested individuals with heightened sensitivity to pain experience tension-type headaches more frequently.1

Question 2

Which of the following is a less common symptom a person with migraine might experience?

Answer: Phantosmia

Phantosmia—also known as phantom smells—are a rare type of migraine aura.2 Aura frequently causes vision problems, and happens before the headache phase of a migraine attack, but for some, aura can also lead to the hallucination of scents. The most common scent, according to research, is the scent of smoke or of something burning.3

Question 3

A patient describes a sudden, severe headache that is the "worst headache of their life." This could be a sign of:

Answer: Thunderclap headache

Thunderclap headaches are serious business. They come on quickly—without warning—and are extremely painful. Thunderclap headaches can be divided into 2 categories: those with no clear cause that are benign, and those that are a symptom of something more serious.4 The latter category can include conditions such as subarachnoid hemorrhage, reversible cerebral vasoconstriction syndrome, intracerebral hemorrhage, subdural hematoma, cervical artery dissection, ischemic stroke, spontaneous intracranial hypotension, or an acute hypotensive crisis, among others.5

Question 4

Which of the following is a characteristic symptom of cluster headache that is not typically seen in migraine?

Answer: Restlessness and agitation during an attack

Cluster headaches are so named because these headache attacks occur in groups or clusters. These headaches are brief but “excruciating” in severity, recurring between 1 and 8 times a day, with cycles lasting weeks to months. The pain searing, stabbing pain is described as 10/10 in severity. But unlike those experiencing migraine—who may typically seek out a dark, quiet place to lie down—individuals with cluster headaches can find it difficult to stay still and rarely lie down.6

Question 5

Sinus headaches are frequently confused with migraine headaches. Some of the most common symptoms of sinus headaches include:

Answer: Stuffy nose, facial pain, and aching in the upper teeth

It’s not uncommon for symptoms of sinus headache to be confused with those of a migraine attack: 90% of headaches that are self-diagnosed as sinus headaches are actually migraine, and sinus headaches (rhinosinusitis) are much rarer than many realize. True sinus headaches are caused by a viral or bacterial sinus infection and are characterized by thick and discolored nasal discharge.7

References
1. What is tension-type headache? American Migraine Foundation. January 12, 2023. Accessed June 5, 2024. https://americanmigrainefoundation.org/resource-library/tension-type-headache/
2. 9 surprising symptoms of a migraine attack. American Migraine Foundation. January 20, 2022. Accessed June 5, 2024. https://americanmigrainefoundation.org/resource-library/9-surprising-migraine-symptoms/
3. Coleman ER, Grosberg BM, Robbins MS. Olfactory hallucinations in primary headache disorders: Case series and literature review. Cephalagia. 2011;31(14):1477-1489. doi:10.1177/0333102411423315
4. What is a thunderclap headache? American Migraine Foundation. April 19, 2023. Accessed June 5, 2024. https://americanmigrainefoundation.org/resource-library/thunderclap-headaches
5. Sekhon S, Sharma R, Cascella M. Thunderclap headache. StatPearls. Updated June 4, 2023. Accessed June 5, 2024. https://www.ncbi.nlm.nih.gov/books/NBK560629/
6. Understanding cluster headache. American Migraine Foundation. April 18, 2019. Accessed June 5, 2024. https://americanmigrainefoundation.org/resource-library/cluster-headache-2
7. How to know if you have migraine or sinus headache. American Migraine Foundation. September 20, 2023. Accessed June 5, 2024. https://americanmigrainefoundation.org/resource-library/sinus-headache
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