Comprehensive Headache Center

Migraine is more than just a headache. It is a neurological condition that can cause repeated episodes of moderate to severe head pain, often accompanied by other symptoms such as nausea, sensitivity to light and sound, or visual changes.

Common Symptoms

• Throbbing or pulsating head pain (often on one side)
• Nausea and/or vomiting
• Sensitivity to light, sound, or smells
• Blurred vision or visual disturbances (“aura”)
• Fatigue or difficulty concentrating

What Triggers Migraine?
Triggers vary for each person, but common ones include stress, changes in sleep, skipped meals, dehydration, hormonal changes, and certain foods or environmental factors.

Treatment Options

Migraine can be managed with a combination of:

• Acute treatments (taken at the start of an attack to reduce pain and symptoms)
• Preventive treatments (taken regularly to reduce how often migraines occur)
• Procedures and therapies such as Botox, nerve blocks, and infusion therapy for certain patients
• Lifestyle strategies including regular sleep, hydration, stress management, and exercise

Living with Migraine

Although migraine can be disabling, effective treatments and healthy lifestyle habits can significantly reduce symptoms and improve quality of life. Working with a headache specialist can help you find the treatment plan that fits your needs.

Cluster headache is a severe type of headache that occurs in groups (“clusters”). These headaches are extremely painful, often described as a burning or stabbing pain behind one eye or on one side of the head. They come suddenly, usually at the same time each day, and can last for weeks or months in cycles, followed by headache-free periods.

Key Symptoms

• Severe one-sided pain (usually around or behind the eye)
• Short but intense attacks lasting 15 minutes to 3 hours
• Occur up to 8 times per day during a cluster period
• Associated symptoms on the painful side:
  • Red or watery eye
  • Stuffy or runny nose
  • Drooping eyelid or swelling
  • Sweating on the forehead
• Restlessness or pacing during an attack (many patients cannot sit still)

Triggers and Patterns

• Cluster headaches often follow a seasonal pattern, sometimes linked to changes in sleep or body clock.
• Common triggers during cluster periods include alcohol, strong odors, and changes in sleep.

Diagnosis

Cluster headache is diagnosed based on your history and symptoms. Brain imaging may be ordered to rule out other causes.

Treatment Options

There is no cure, but effective treatments are available.

Acute (for attacks):

• Oxygen therapy (breathing pure oxygen through a mask)
• Injectable or nasal spray triptans (e.g., sumatriptan, zolmitriptan)

Preventive (to reduce frequency and severity):

• Medications such as verapamil, lithium, or short courses of steroids
• Newer therapies, including CGRP monoclonal antibodies
• Nerve blocks in some cases

Lifestyle tips:

• Avoid alcohol during cluster periods
• Keep a regular sleep schedule
• Track your headache patterns to share with your doctor

Living With Cluster Headache

Cluster headaches can be overwhelming, but with the right treatment plan, many patients achieve significant relief. Having a care team that understands your condition can make a big difference.

Resources & Support

• Clusterbusters – patient advocacy and education
• National Headache Foundation
• American Migraine Foundation 

Tension-type headache (TTH) is the most common type of headache. It often feels like a constant, dull pressure or tightness on both sides of the head — sometimes described as a “band around the head.” While not as disabling as migraine, frequent tension-type headaches can affect daily life.

Key Symptoms

• Mild to moderate pressure-like pain (not throbbing)
• Pain often felt on both sides of the head
• Sensation of tightness or squeezing, like a “tight band”
• Headache may last from 30 minutes to several hours (sometimes days)
• Usually not associated with nausea or vomiting
• Light or sound sensitivity may occur, but not both together
• Does not worsen with routine physical activity (walking, climbing stairs)

Triggers and Risk Factors

• Stress, anxiety, or emotional strain
• Poor posture or long hours at a desk
• Eye strain
• Fatigue or lack of sleep
• Skipping meals
• Teeth grinding or jaw clenching

Diagnosis

Tension-type headache is diagnosed based on your symptoms and medical history. Unlike migraine or cluster headache, there are no specific tests, but your doctor may rule out other causes if needed.

Treatment Options

Acute (for individual headaches):

• Over-the-counter pain relievers such as acetaminophen or ibuprofen
• Stress management and relaxation techniques

Preventive (for frequent or chronic TTH):

• Prescription medications (such as low-dose antidepressants)
• Physical therapy, posture correction, or biofeedback
• Stress reduction strategies, including mindfulness, yoga, or counseling

Lifestyle tips:

• Maintain good posture and take breaks from screens/work
• Stay hydrated and get regular exercise
• Practice relaxation techniques (deep breathing, meditation)
• Ensure regular sleep and balanced meals

Living With Tension-Type Headache

Most people experience occasional tension headaches. However, if headaches are frequent (more than 15 days per month), they may be considered chronic tension-type headaches. With the right lifestyle changes and medical care, symptoms can be well-managed.

Resources & Support

• American Migraine Foundation – information on tension-type and other headache disorders
• National Headache Foundation – education and patient resources
• Stress management and relaxation programs in your community

Trigeminal neuralgia (TN) is a chronic pain condition that affects the trigeminal nerve, which carries sensation from your face to your brain. It causes sudden, severe, shock-like facial pain, often triggered by everyday activities like eating, talking, or even a light touch.

Key Symptoms

• Intense, stabbing or electric shock–like facial pain
• Usually affects one side of the face (cheek, jaw, teeth, gums, or lips)
• Attacks can last seconds to a few minutes but may occur repeatedly throughout the day
• Pain-free periods between attacks are common, especially early on
• May be triggered by:
  • Chewing, speaking, or smiling
  • Touching the face, brushing teeth, shaving, or washing
  • Cold air or wind

Causes

• Most cases are due to compression of the trigeminal nerve by a blood vessel near the brainstem.
• Rarely, multiple sclerosis or a tumor pressing on the nerve may be the cause.
• Sometimes, no clear cause is found.

Diagnosis

Diagnosis is usually based on symptoms and a neurological exam. Your doctor may order an MRI scan to look for nerve compression or other conditions.

Treatment Options

Medications (first-line treatment):

• Anti-seizure medications (e.g., carbamazepine, oxcarbazepine)
• Other medicines may be added if pain persists

Procedures (for cases not controlled with medication):

• Nerve blocks or injections
• Minimally invasive procedures (e.g., Gamma Knife radiosurgery, radiofrequency ablation)
• Microvascular decompression surgery (relieves pressure from blood vessel on the nerve)

Living With Trigeminal Neuralgia

• Although TN can be extremely painful, treatments can significantly improve quality of life.
• Keeping a pain diary helps track triggers and responses to treatment.
• Emotional support and patient groups may help cope with the condition.

Resources & Support

• Facial Pain Association – support and advocacy for patients with TN and related disorders
• American Academy of Neurology – information on neurological disorders
• National Institute of Neurological Disorders and Stroke – research and patient resources

A post-traumatic headache (PTH) is a headache that develops after a head injury, such as a concussion, fall, sports injury, or motor vehicle accident. Headaches are one of the most common symptoms following a traumatic brain injury, even when the injury is considered “mild.”

When Do Post-Traumatic Headaches Occur?

• They usually begin within 7 days of the injury.
• Some resolve within weeks, while others may persist for months or longer.
• If headaches continue for more than 3 months, this is called persistent post-traumatic headache

What Do They Feel Like?

Post-traumatic headaches can mimic other common headache types, such as:

• Migraine-like headaches (throbbing pain, sensitivity to light or sound, nausea).
• Tension-type headaches (dull, pressure-like pain, often on both sides of the head).
• Cervicogenic headaches (pain starting in the neck and radiating to the head

Other Symptoms After Head Injury May Include:

• Dizziness or balance problems
• Difficulty concentrating or memory issues
• Fatigue or sleep disturbances
• Mood changes such as irritability, anxiety, or depression

When Should You Seek Care?

You should see a doctor urgently if you have:

• Sudden, severe headache that is the “worst headache of your life”
• Worsening headache after an injury
• Headache with vomiting, vision changes, weakness, numbness, or trouble speaking
• Confusion, seizures, or difficulty staying awake
• These symptoms may signal a more serious condition requiring immediate evaluation.

How Are Post-Traumatic Headaches Treated?

There is no “one-size-fits-all” treatment, but at the Baylor Headache Center we offer:

• Medication management (acute treatments for attacks and preventive medicines)
• Nerve blocks and procedures for pain relief in selected cases
• Infusion therapy for severe or prolonged headaches
• Lifestyle and non-medication strategies such as sleep optimization, hydration, physical therapy, and stress management
• Collaboration with pain psychology for coping strategies when symptoms affect daily life

Resources for Patients and Families

Learning more about post-traumatic headaches can help you better understand your condition and recovery. Here are some trusted resources:

• American Migraine Foundation – Post-Traumatic Headache
• Brain Injury Association of America – Concussion and Brain Injury Resources
• Centers for Disease Control and Prevention (CDC) – Concussion and Mild TBI
• National Headache Foundation

These organizations provide patient-friendly guides, educational materials, and support options for individuals and families coping with post-traumatic headaches.

Medication overuse headache (sometimes called “rebound headache”) happens when pain-relief medicines are used too often. Instead of helping, the frequent use of these medicines can actually make headaches occur more frequently and become harder to control.

Why Does It Happen?

The brain becomes more sensitive to pain signals when exposed to frequent headache medication. Over time, this can lead to a cycle of daily or near-daily headaches.

Medicines That Can Cause MOH:

• Over-the-counter pain relievers (ibuprofen, acetaminophen, aspirin, naproxen)
• Combination medicines with caffeine or butalbital
• Triptans (migraine-specific medicines)
• Opioids (such as codeine, hydrocodone)

Risk is higher if these medicines are used more than 10–15 days per month, depending on the type.

Common Signs of MOH:

• Headaches almost every day, often worse in the morning
• Headaches that improve temporarily with medication but return when it wears off
• Increasing need for pain medication to get relief
• Headaches that worsen when trying to stop medication

When to Seek Care:

If you find yourself taking headache medicine most days of the week, or if your headaches have become more frequent and difficult to control, it’s important to see a headache specialist. Stopping overused medication suddenly may worsen headaches in the short term, so medical guidance is strongly recommended.

Resources for Patients and Families:

Here are some trusted sources to learn more about MOH:

• American Migraine Foundation – Medication Overuse Headache
• National Headache Foundation – Rebound Headache
• Mayo Clinic – Medication Overuse Headache
• American Academy of Neurology – Patient & Caregiver Resources

Idiopathic intracranial hypertension (IIH), also called pseudotumor cerebri, is a condition where the pressure inside the skull is too high without an obvious cause, such as a tumor or infection. This pressure can affect the brain and the optic nerves, sometimes leading to vision changes if untreated.

Key Symptoms

• Daily or near-daily headaches, often worse when lying down
• Vision problems, such as blurred vision, double vision, or brief episodes of vision loss
• Pulsatile tinnitus (hearing a whooshing sound in the ears)
• Pain behind the eyes
• Nausea and vomiting (from high pressure)
• Swelling of the optic nerve (papilledema), seen on eye exam

Who is at Risk?

• Most common in women of childbearing age
• More frequent in people with overweight or obesity
• Sometimes linked to certain medications (e.g., vitamin A derivatives, tetracyclines, hormonal treatments)

Diagnosis

IIH is diagnosed with a combination of:

• Eye exam (to check for papilledema)
• Brain imaging (MRI/MRV) to rule out other causes
• Lumbar puncture (spinal tap) to measure cerebrospinal fluid (CSF) pressure

Treatment Options

Lifestyle & Medical Treatment:

• Weight loss (even 5–10% of body weight can improve symptoms)
• Medications to reduce CSF pressure (acetazolamide, topiramate)
• Regular eye exams to monitor vision

Procedures & Surgery (if vision is at risk):

• Repeated lumbar punctures (temporary relief)
• Optic nerve sheath fenestration (to protect vision)
• CSF shunt surgery (to drain excess fluid)
• Venous sinus stenting (for selected patients with venous narrowing)

Living With IIH

IIH can be a long-term condition, but with early diagnosis and treatment, most patients maintain good vision and control of symptoms. Regular follow-up with both a neurologist and an eye specialist (neuro-ophthalmologist or ophthalmologist) is essential.

Resources & Support

• IIH UK – patient support and advocacy
• American Academy of Neurology – patient information on neurological disorders
• National Eye Institute – vision-related resources
   

Spontaneous intracranial hypotension (SIH) is a condition caused by a spinal fluid (cerebrospinal fluid, CSF) leak around the brain or spinal cord. Because CSF cushions the brain, when it leaks, the brain sags downward, leading to headaches and other symptoms. The leak often happens without injury or clear cause, which is why it is called “spontaneous.”

Key Symptoms

• Headache that worsens when standing and improves when lying down (postural headache)
• Neck pain or stiffness
• Nausea, dizziness, or imbalance
• Ringing in the ears (tinnitus) or hearing changes
• Sometimes double vision or other cranial nerve symptoms
• In severe or untreated cases: confusion or difficulty concentrating

Causes and Risk Factors

• Small tears in the covering of the spinal cord (dura), often at weak spots
• Sometimes linked to connective tissue disorders (like Ehlers-Danlos syndrome)
• May follow minor trauma or straining, though often no cause is found

Diagnosis

SIH can be challenging to diagnose. Tests may include:

• MRI of the brain and spine (looking for “sagging brain” signs or fluid collections)
• CT myelography or digital subtraction myelography to locate the leak
• Lumbar puncture may show low CSF pressure, though this is not always required

Treatment Options

Conservative Management (mild cases):

• Bed rest, hydration, caffeine, and sometimes medications to relieve symptoms

Procedures:

• Epidural blood patch (injection of a small amount of your own blood near the leak to seal it)
• Targeted patching with fibrin glue or surgery if the exact leak site is identified

Surgery:

• In rare or persistent cases, neurosurgery may be needed to repair the leak directly

Living With SIH

With timely treatment, most patients recover fully. However, delays in diagnosis can lead to prolonged symptoms. Follow-up imaging and specialist care are often needed to ensure the leak has sealed.

Resources & Support

• Spinal CSF Leak Foundation – education, support, and advocacy
• American Headache Society – professional and patient resources
• Patient support communities can provide tips for coping and recovery