When you have a headache the doctor will want to know about the location of the pain, its quality, its intensity, the time when it comes on, and the way it is influenced by moving, reading, noise, and other factors. Usually a headache is a dull, aching pain, that arises from the structures within the skull. Sometimes a headache may be associated with a disturbance in the sinuses, or the eyes, or in the bones in the upper part of the spine.
Sensitivity to pain in the head varies in different people and in the same person at different times. The worst headaches are those associated with inflammations or infections of the meninges, which are the tissues that cover the brain. When a sudden, sharp pain affects the head the sensation may be due to a branch of the facial nerve. Usually headaches last longer, for minutes or even hours. When the headache is described as “throbbing” the effect comes from transmission of the pulse in the blood vessels.
A headache may be associated with exposure to cold. Other headaches may develop in healthy people during periods of great fatigue or emotional stress. Such headaches occur towards the end of the day; they begin as a dull ache in the forehead and spread towards the temples or towards the back. These headaches disappear when the person concerned has some good rest or sleep. Fear and worry seem to make headaches worse. Some headaches come from tenseness of the facial muscles, which in turn may be caused by pain or anxiety or strain.
Psychologic disorders or mental disturbances may also be reflected in pains which are referred to the head. Such people complain of pressure on the head, of a tight-fitting band which squeezes the head, or of a pain that presses on the very top of the head.