What Causes Headaches Again?

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You have headaches. But how can you determine what causes them? There is so much information on the internet. Unfortunately, some of it may contain misleading ideas. There are two types of headaches: primary and secondary. Primary headaches are those in which the headache is the main cause and not an underlying medical condition.

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90% of headaches that are brought to a doctor’s attention are due to primary causes like migraine, cluster, and tension headaches. Tension headaches can be either chronic or episodic. These headaches are usually not caused by structural brain problems, but tingling, numbness, and dizziness can occur. Normal imaging studies such as CT scans or MRIs of brain are also possible. The exam for a patient suffering from one of these types headaches is usually normal. However, tension headache patients may experience cervical spasming, which can lead to migraines.


The feedback system in the cervical spine activates when there is spasming in the neck muscles. This triggers the brain’s central part responsible for the migraine cascade. The migraine can be as quick as a few hours away once this happens. Secondary headaches are easier to identify. These headaches are caused by an underlying medical condition like diabetes (hypoglycemic migraine), hypertension, lupus and anemia.

This group also includes headaches associated with meningitis or brain tumors. Secondary headaches are not the primary problem. They are part of a series of symptoms. The true problem is the underlying diagnosis. The abnormalities may be revealed by lab work or other tests. A physical exam may also show abnormalities. Meningitis, diabetes, tumors, and cancer may present with what we call “neurological signs”. These include loss of feeling, weakness and slurring speech, neck pain, cognitive difficulties, and even loss of feeling.


When headaches are a part of a patient’s complaint, it is important for doctors to listen to the patient. Tell your doctor about the severity, timing, and nature of your headaches. Let your doctor know what makes them worse or better. The underlying condition can not only relieve your headaches but may even save your life.