Health Care

Headaches 101

Woman having a migraine
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Headaches can be a real pain, but when is a headache just a headache and when is it something more serious? To find out all about headaches and what symptoms could indicate more serious conditions we spoke with our own neurologist and headache specialist, Nitzmari Melendez Vasquez, MD.

Diagnosing Headaches

“The first step in diagnosing the variety and severity of headaches is done with a headache calendar in which you keep a record of your headaches and symptoms every day for a month,” explains Dr. Melendez Vasquez. “By completing a headache calendar, we are then able to look over the frequency and symptoms that are associated with your headaches as well as for patterns and possible triggering factors.”

There are many causes for common headaches and migraines alike. Some of them may be linked to your lifestyle and daily routines. While completing your month of tracking with your headache calendar, your doctor might make the following recommendations:

  • Stay properly hydrated by drinking plenty of water throughout the day
  • Maintain a healthy, well-rounded diet that contains as few processed foods as possible
  • Limit your intake of sugar and sugary drinks and foods as much as possible or cut them out altogether
  • Cut down on your caffeine intake drastically or altogether
  • Make sure you’re getting the proper amount of sleep and are well rested
  • Limit your exposure to stress as much as possible

These steps alone may reduce or eliminate the number of headaches that you experience.


“Migraines are associated with common symptoms and come in two varieties: Aura and Non-Aura,” says Dr. Melendez Vazquez. “A migraine is different than your normal headaches in that they are often accompanied with nausea or vomiting, phonophobia, which is an aversion to noise that causes pain, and photophobia, which is an aversion to light that causes pain. Migraines are usually unilaterally centered, most commonly in the frontal area in children and temporal area in adults and will generally last two hours in children to four hours or longer in adults, sometimes even for days.”

Most patients with migraine headaches can have some symptoms before the onset of the headache which can act as a warning system, alerting you to the oncoming migraine. An aura is an episode of focal, transitory neurologic dysfunction before the onset of the headache. The patient can experience different types of aura including visual auras, somatosensory aura (numbness or tingling sensation), speech and or language problems, and motor deficit, among others. Non-aura migraines, on the other hand, can seem like they’ve come out of nowhere or they can have symptoms that are usually nonspecific which can include changes in mood or behavior like irritability, anxiety depression, difficulty thinking, problems with concentration, reading, writing or speaking, excessive tiredness, food craving or anorexia within others.

While the mechanism of migraines remains incompletely understood there are some theories that may explain part of the migraine syndrome. These theories include vascular, a complex series of vascular and neural events, and cortical spreading depression. The causes of migraines can be multifactorial but there is a heavy genetic component to them that is handed down through generations.

Either variety of migraine will generally leave you rendered unable to work or carry on with life as usual. These debilitating headaches are far removed from a normal headache with greater intensity and diminished quality of life.


The first step in headache management is lifestyle modification which tries to identify and correct possible triggering factors. “If you suffer from headaches at a rate of one or two a week or month we will try to treat you for an acute event with medications like Ibuprofen or triptans as needed,” explains Dr. Melendez Vazquez. “If the headaches frequency is more than twice per week or if each event persists longer than 24 hours, you may need preventive treatment to decrease the frequency and intensity of headaches which can include antihistamines, antidepressants and antiseizure medications depending on patient age and clinical symptoms.”

When is a Headache More Than Just a Headache?

“Headaches can be indicators of much larger problems, like meningitis, a concussion, a brain tumor, or other conditions that require immediate attention from a doctor,” says Dr. Melendez Vasquez. “If you or your loved one are having any of the following symptoms, please be sure to seek medical treatment as soon as possible.”

  • Frequent and severe headaches
  • If you’re awoken by the headache
  • A noticeable change in behavior associated with the headache
  • Changes in behavior that occur after the headache has stopped
  • If a child under six years of age has a headache that feels like it’s in the back of their head
  • After a head trauma or injury

Get Help for Your Headaches

If you believe that you’re suffering from headaches or migraines, we’re here to help. Learn about your treatment options by visiting our website or call Call855-303-DOCS to make an appointment with one of our headache specialists.

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