There are several types of headaches that are described. The types are categorised according to the location on the head where the pain originates. Headaches are also described according to how the headache starts, and what happens to the headache with time.
The occipital region refers to the back of the head. Patients seeking help for occipital headache may be diagnosed with migraine headache. Migraine is a severe type of headache that often has some warning signs that it is coming. The warning signs may include visual flashes (visual aura), nausea, agitation or other symptoms.
Another cause of occipital headache is occipital neuralgia. There are nerves that transmit the sensation impulses from the skin at the back of the head (the occiput). They are called the occipital nerves. The nerves may be compressed or irritated by spasms of the occipitalis muscle, an enlarged blood vessel compressing the nerve, or some tight connective tissue.
Occipital neuralgia is one of the more common types for which there is treatment other than medications. Occipital neuralgia may be treated with injections or surgical decompression, depending on the exact cause.
The frontal region is the front of the head. Patients with frontal headaches may have “tension headache” or “migraine headache” as possible diagnoses.
Frontal headache can also occur as a result of nerve irritation or compression.
When this type of headache pain occurs secondary to nerve compression or irritation, it is usually related to the supraorbital and/or supratrochlear nerves which are branches of the trigeminal nerve. The Trigeminal Nerve is the main nerve that carries sensory impulses for the face.
The nerve branches can be compressed by some of the muscles of the face. When this is the case, the headache may be treated with muscle relaxant injections to relax those compressive muscles. Pain may also be caused by the nerves being compressed by fascia that is very tight. This can occur around the eye socket.
The temporal region refers to the side of the head. Headache symptoms at the side of the head can be attributed to Tension Headache or Migraine, but Temporal Headache can also be caused by nerve irritation or compression.
There are two main nerves that can be affected, both of which are branches of the Trigeminal Nerve:
- The auriculotemporal nerve
- The zygomaticotemporal nerve
The auriculotemporal nerve is located in the scalp near the top of the ear. In this area, the nerve may be compressed by the connective tissue and the superficial temporal artery or vein which may be enlarged or passing immediately next to the nerve.
The zygomaticotemporal nerve is found between the eye and the hairline. Here, the nerve may be trapped by tight connective tissue overlying the temporalis muscle. There can also be blood vessels irritating the nerve here.
How is the Type of Headache Evaluated?
The important information to ascertain includes:
- The nature of the headaches
- Previous treatments and whether or not they have been effective
- Full medical history
- Physical examination
Usually Dr Sammons would organise some nerve blocks to see what, if any, result is achieved with these.
How do I Know if Surgical Decompression Might Help?
When traditional methods have failed, Dr Sammons may be able to help. We know that nerves all over the body can be compressed and this causes nerve dysfunction. Patients with chronic headache or migraine can suffer from nerve compression which is similar to what Dr Sammons treats in other parts of the body. With a proper assessment, Dr Sammons may be able to recommend surgery that is relatively minor and can have excellent outcomes.
Contact Dr Sammons’ rooms for an appointment if you wish to talk about your headaches and the possibility of surgical treatment.