Swollen blood vessels in your head can lead to severe, throbbing pain. Several types of these so-called vascular headaches exist, with varying symptoms.
If you have a severe, throbbing headache that gets worse when you move and makes you nauseated, it could be a vascular headache.
According to the National Migraine Foundation, this category includes migraine, cluster and toxic headaches 15. All involve blood vessels in your head that swell or widen — called vasodilation — but the causes and symptoms differ.
“Vascular headache is not one type of headache," says Zubair Ahmed, MD, a neurologist and headache specialist at the Cleveland Clinic Center for Neuro-Restoration in Cleveland, Ohio. "It is a group of headaches that include pain caused by irritation or swelling of blood vessels."
"Brain tissue does not sense pain," Dr. Ahmed explains. "Blood vessels do sense pain and can cause throbbing or pulsating types of headache."
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"Migraine headaches cause moderate-to-severe pain on one side of your head" Dr. Ahmed says. "The headache can be made worse by light or sound and often causes nausea or vomiting." He says such headaches generally last from 4 to 72 hours.
Getting a migraine diagnosis means you've experienced the signs and symptoms and have had such attacks at least five times. Migraines, which affect about 10 percent of the population, are three times more common in women than men, according to the National Institutes of Neurological Disorders and Stroke (NINDS) 2. They usually start during adolescence or young adulthood. About a third of people who experience migraines have warning signs before an attack, called migraine aura, which usually includes visual changes.
For many years, researchers thought migraines were caused by fluctuations in blood flow to the brain, says Johns Hopkins Medicine 4. While those changes may contribute to the pain, they're not the actual cause. Research now suggests that migraine may be genetic, says NINDS.
This type of vascular headache is similar to a migraine but less common, and can be very painful. Cluster headaches cause extreme pain around or behind one eye, says the National Headache Foundation 156. The pain starts suddenly and quickly gets worse, and it may include nasal congestion, redness and tearing of the eye and flushing on the side of the face, according to the foundation.
Cluster headache attacks last up to three hours and can occur up to eight times each day for 6 to 12 weeks, says the Genetic and Rare Disease Information Center (GARD) at the National Institutes of Health 356. They're much more common in men than women, it says.
The cause of cluster headaches is not completely known. According to the National Organization for Rare Disorders, recent studies implicate the hypothalamus, a region of the brain that controls your sleep cycles 56. What is known is that cluster headaches are often triggered by drinking alcohol—especially red wine—and by smoking, says GARD.
Vascular headaches that develop from other causes are called toxic headaches. Common causes of blood vessel swelling that leads to these headaches include:
- Fever. Fever causes vasodilation and is one of the reasons people have headaches when they have a cold or the flu.
- Certain medications. Drugs used to treat high blood pressure or heart failure may cause vasodilation headaches, the NIH says.
- High blood pressure. High blood pressure is sometimes called the silent killer because it rarely causes symptoms. But, if your blood pressure is very high, it can cause vasodilation and a throbbing headache. This headache is more common in the morning and can feel like a band of pressure around your head, notes the National Headache Foundation 15.
- Caffeine withdrawal. If you drink too much coffee, your brain starts to depend on caffeine. Suddenly stopping causes vasodilation and headache, according to NIH.
- Hangover. Most people are familiar with the throbbing head and nausea of a hangover headache. Symptoms are similar to a migraine, but on both sides of your head. Too much alcohol causes the vasodilation and irritation.
The Bottom Line
If vascular headaches are chronic, you "need a diagnosis and proper treatment,” says Dr. Ahmed. “The treatment is different for each type. Your best bet is to work with a headache specialist.”
What is known is that cluster headaches are often triggered by drinking alcohol—especially red wine—and by smoking, says GARD. Common causes of blood vessel swelling that leads to these headaches include: * Fever. Read more: This type of vascular headache is similar to a migraine but less common, and can be very painful.
- National Headache Foundation: “Vascular Headaches”
- National Institute of Neurological Disorders and Stroke: “Migraine Information Page”
- Genetic and Rare Disease Information Center/National Institutes of Health: “Cluster Headache”
- Johns Hopkins Medicine: "How a Migraine Happens"
- National Headache Foundation: "Cluster Headache"
- National Organization for Rare Disorders: "Cluster Headache"