There are two types of headaches, primary and secondary. Primary headaches are not caused by other medical conditions and include migraines, cluster headaches, and tension headaches. Secondary headaches usually result from another medical condition and can be a sign of an underlying health problem such as fever, infection, high blood pressure, stroke, head injury, or brain tumor. Understanding the difference between primary and secondary headaches can alert you to seek medical treatment.

What is a Primary Headache?

Primary headaches are much more common and include migraines. While migraine headaches can be very painful and even debilitating, they do not indicate a more serious health problem. Even though migraines are not a sign of a more serious health problem, it is important to discuss your migraines with your primary care physician to determine a treatment plan to lessen the pain and frequency of the migraine.

What is a Secondary Headache?

Secondary headaches are relatively rare and are broken up further into two categories, benign and ominous. Benign headaches are reactions to a temporary condition, such as a headache caused by medication overuse. Ominous headaches are a precursor to a health event or condition, such as “thunderclap” headache signaling a brain hemorrhage.

What are Characteristics of a Secondary Headache?

Some characteristics of a secondary-headache that may indicate a serious problem include:

  • a severe headache that comes on abruptly without buildup;
  • increased frequency or a change in the character of recurrent headaches;
  • headaches that start either early on or later in life (under 5 or over 50);
  • headache accompanied by weakening or loss of vision;
  • headache accompanied by fever;
  • the first or worst headache of your life;
  • and the presence of cancer, HIV or pregnancy.

If you have a headache with any of these symptoms, it is important to get an evaluation by a health professional as soon as possible. Ignoring the symptoms can cause long-term damage.

While most headaches are not life-threatening, it is important to recognize the warning signs when they are. If you experience recurrent headaches, a headache journal is helpful in identifying patterns and the type of headaches you experience. In the journal, note specifics such as what you were doing when the headache started, the time of day, accompanying symptoms, the headaches frequency, duration, and intensity. Also note in the journal any medication usage and changes in headache pattern. The headache journal will prove a valuable resource in determining if an isolated headache is primary or secondary.


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