The Vanderbilt Headache Clinic was established by Dr. John S. Warner and Dr. Gerald Fenichel. Physicians in the Headache Clinic evaluate and treat patients with chronic headaches— most commonly, migraine headaches. Other types of primary headaches include:

• cluster headaches
• hemicrania continua
• hypnic headache
• tension headaches
• headaches caused by underlying disorders such as pseudotumor cerebri and other conditions 

While most headaches do not necessitate a doctor’s visit, headache suffers should seek medical advice if the following red flags are present: first or worst headache, abrupt onset, onset after age 50, progressive worsening, headache on awakening or that awakens, a change in the pattern of an established chronic headache, poor response to medication, persistent numbness or weakness.

Migraines

A migraine is a complex disorder of the nervous system: in addition to the head pain, presenting symptoms include nausea, vomiting, one-sided pain (hemicrania – which gives the disorder its name), phonophobia, photophobia, and osmophobia (increased sensitivity and intolerance to odors). Click here to read more about migraines.About 20% of patients have an aura. An aura is a transient focal neurological disturbance which is typically a visual disturbance and lasts 15-20 minutes; the pain lasts 3-72 hours. Click here to read more about migraines.

Chronic Daily Headache (Rebound Headache)

A chronic daily headache, also known as a rebound headache, affects about 3-5% of the population and accounts for about 70% of visits to headache clinics. A chronic daily headache is one that occurs more than15 days per month; generally they last more than four hours per day and are often caused by the regular use of simple medication taken for pain relief. The medication taken to relieve today’s headache wears off and “rebounds” to cause tomorrow’s headache— thus the name analgesic rebound headache (also called medication overuse headache).

The exact cause of a rebound headache is unknown. It is neither an allergic reaction nor due to medications or their breakdown products in the body. It is also not an emotional disorder. Current evidence suggests that, in some people, the chronic use of pain relievers alters serotonin receptors in the pain pathways of the brain; these changes are slowly reversed after the pain relievers or other offending agents are discontinued. Click here to read more.