Headaches Overview - Primary vs Secondary Headaches



What’s the Core Difference?

 • Primary headache = headache is the disease itself

 • Secondary headache = headache is a symptom of something else



🧠 Primary Headaches

These are not dangerous, just painful and recurrent.  Use the mnemonic "Mi-T-C":

 • Migraine – Unilateral, throbbing, ± aura, nausea, photophobia

 • Tension – Bilateral, tight band, dull, non-pulsatile

 • Cluster – Unilateral, around eye, tearing, rhinorrhea, severe



🎯 Key Features:

 • Tension: Band-like pressure, both sides

 • Migraine: Throbbing, one side, nausea, aura

 • Cluster: Severe, one eye, tears, same time daily



⚠️ Secondary Headaches – Use the mnemonic "VITAMIN C" (common for causes in medicine):

 • Vascular (e.g., stroke, aneurysm)

 • Infection (e.g., meningitis)

 • Trauma (e.g., concussion)

 • Arteritis (e.g., temporal arteritis)

 • Mass (tumor)

 • Increased pressure (e.g., hydrocephalus)

 • Neurologic (e.g., seizures)

 • Chemical (e.g., CO poisoning)



These can be life-threatening. Always rule these out if:

 • Sudden onset (“worst headache of life”)

 • Headache + fever, confusion, vision change

 • Headache in immunocompromised or elderly



⚠️ Common Secondary Causes:

 • SAH (Thunderclap)

 • Meningitis (fever + neck stiffness)

 • Brain tumor (worse with Valsalva)

 • Temporal arteritis (jaw claudication + ESR ↑)

 • HTN emergency, CO poisoning, glaucoma



🚩 Red Flag Features (SNOOP):

S	Systemic (fever, weight loss, cancer, HIV)

N	Neurological signs (seizure, confusion, focal signs)

O	Onset: sudden or “thunderclap”

O	Older (>50 years)

P	Pattern change or progressive headache



#Headaches #Primary #Secondary #Comparison #Neurology #Diagnosis