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live in good health Head Games Whether they strike every once in awhile or every day, understand your headache pain with a quick lesson on three types of primary headaches from Dr. Douglas Dulli, professor of neurology with the University of Wisconsin School of Medicine and Public Health What the Doctor Orders Migraine headache What it is: Th ough migraines are brought on by an electrical discharge in the brain, many sufferers begin to pinpoint factors that may trigger their pain. "Th is phe- nomenon is not well understood," Dulli says. "[But] exposure to cigarette smoke, perfumes or other odors can be triggers, along with some bright lights. Th ere are also menstrual-associated migraines." Symptoms: Migraine sufferers often ex- perience pain in one area of the head as well as pain or diffi culty with movement. Onset often follows a common pattern. "You'll feel out of sorts, then so-called focal pain begins, which often starts in one area of the face, then more generalized pain along with nausea, vertigo and sensitivity to light and sound," Dulli explains. When to see your doctor: If you fre- quently rely on medications or experience a headache accompanied by neurologic symptoms such as double vision or weak- ness or numbness on one side of the body, a trip to your physician is in order. Tension-type headache What it is: More random in occurrence, these types of headaches often follow tem- porary stress, anxiety or fatigue. "Ten- sion-type headaches are not nearly as well defi ned as people like to think," Dulli says. "Th ey follow a similar time-course as a migraine, but they tend to be much more gentle." Symptoms: Many tension-type headache sufferers describe their pain as a band be- ing squeezed around their heads, though Dulli says other headaches may cause this feeling as well. "Th e biggest thing that would differentiate a tension headache from a migraine headache would be the se- verity," he says. When to see your doctor: Many tension headache sufferers fi nd relief from over- the-counter medications. Dulli cautions that if you fi nd yourself taking medication frequently, it may be time to see your doc- tor or to look at stressors in your life you may be able to change. With a headache of any kind, Dulli advises three ground rules for knowing when to see your physician: If the headache lingers, gets more severe or leads to pain you've never experienced before, or is accompanied by neurologic symptoms like double vision or weakness on one side of your body. Cluster headache What it is: Th e most severe type of pri- mary headache, these occur in less than one percent of the population. A cluster headache, like a migraine, comes from an electrical discharge in the brain—only this arises from a much deeper area. Symptoms: Shorter and much more severe, cluster headaches are often ac- companied by symptoms such as tearing or a runny nose. "Th ey also leave a patient extremely agitated," Dulli notes. When to see your doctor: "Th is type of pain often brings a patient to their doctor in itself," says Dulli, though he is quick to note that there can be a delay in diag- nosis of about fi ve years for cluster head- ache sufferers. "Early in the game there is often confusion over what it is," he says. Th e good news is that once diagnosed, cluster headaches can be treated with very positive results. 12 BRAVA Magazine April 2012