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Migraine

Throbbing, often one-sided, moderate–severe, worse with activity, lasting 4–72h, usually with nausea and/or light + sound sensitivity.

Only ~30% have visual aura — most migraine has none. It's a brain disorder; triggers exacerbate it, they don't 'cause' it.

Tension-type

Pressing/tightening 'band', usually both sides, mild–moderate, NOT worse with activity, no nausea.

The most common headache. Often co-exists with migraine and feeds it — both layers may need treating.

Cervicogenic (neck-driven)

One side, starts at the back of the head/neck, provoked by neck movement or posture; often worse on waking, eases with movement.

Confirmed by a diagnostic nerve block — NOT by an MRI (degeneration on MRI is common and doesn't prove it). The most missed cause.

Cluster / autonomic

Severe, strictly one-sided around the eye, with a red/watering eye, blocked nostril or droopy lid, and restlessness; comes in bouts, often at the same time of day.

Distinct from migraine — needs specific treatment. Restlessness (pacing) is a clue vs migraine (lie still).

New daily persistent (NDPH)

A daily headache that you can trace to a specific day it started and never went away.

A different diagnosis — standard migraine drugs often don't work. The clear 'day one' onset is the key clue.

Sinus / rhinogenic

Facial pressure, blocked nose, post-nasal drip, often after a cold.

Real, but over-diagnosed — many 'sinus headaches' are migraine. Confirmed by endoscopy/CT, not by guesswork.

Medication-overuse

A daily/near-daily headache in someone taking acute painkillers very often.

Painkillers on ≥10–15 days/month for >3 months can themselves cause a rebound headache. Fixable, with a doctor-guided step-down.

“Migraine always has aura / nausea.”

False — most migraine has no aura, and presentation varies. Believing this makes people dismiss their own migraine for years.

“A daily headache is just stress / normal.”

A daily headache is never normal. It deserves a proper work-up, not just more painkillers.

“Triggers cause my migraine.”

Triggers exacerbate an underlying disorder; they don't create it. That's why trigger-hunting alone often finds '0 correlation'.

“It's just a sinus headache.”

Often it's migraine — but real sinus disease also exists. Both directions get missed; imaging settles it.

“If scans are clear, nothing's wrong.”

Most primary headaches have normal scans. Diagnosis is made by the pattern against criteria, not only by imaging.