Migraine and Tension-Type Headache
Migraine and tension-type headache are the most common types of headaches. The lifetime prevalence of experiencing a headache at least once is 95% for women and 90% for men. Despite their high prevalence in society, the ease of access to pain relief medications and incorrect diagnoses continue to complicate treatment.

Migraine typically occurs between the ages of 20 and 30, but attacks can continue until the age of 45. The frequency of migraine attacks decreases with age. Women are 2-3 times more likely to experience migraines than men. Migraine headaches are characterized by a throbbing pain (pain that pulsates like a heartbeat) and may be accompanied by nausea, vomiting, and sensitivity to light and sound. The pain is usually unilateral, increases with movement, and lasts between 4 and 72 hours if no pain relief medication is taken. In the group of migraines known as migraine with aura, symptoms such as flashing lights, spots or lines, visual disturbances, numbness or tingling in the limbs or face, and speech difficulties precede the headache and last between 4 and 60 minutes.

According to the ID-Migraine screening tool, if two out of three criteria (nausea, photophobia, and functional impairment associated with headache) are present, a diagnosis of migraine is likely.

Migraine treatment primarily involves avoiding triggering factors, making behavioral and lifestyle changes (not skipping meals, maintaining regular sleep patterns, managing stress, regular exercise, avoiding excessive alcohol intake, etc.), and medical treatment. Treatment can be either abortive or preventive. If there are more than 2-3 attacks per month, daily medications known as preventive treatment may be prescribed.

Tension-Type Headache
Tension-type headache is the most common form of headache. Although many patients do not take it seriously, it can lead to a loss of productivity. It can also coexist with migraine. This type of headache is generally less intense than a migraine, affects both sides of the head, has a pressing or tightening quality, and does not worsen with movement. It is usually localized to the forehead, temples, or the back of the neck. Tension-type headaches are more common in women. They typically begin between the ages of 20 and 30 and decrease in frequency with age. They are activated by environmental and psychological factors. Psychiatric complaints such as anxiety and depression may accompany them. Treatment, when necessary, involves medications and supportive therapies, sometimes with the assistance of a psychiatry department.

In addition to the most common types of migraine and tension-type headaches, there are other headache types that require detailed history, examination, and investigation by a neurologist, such as cluster headaches, paroxysmal hemicrania, stabbing headaches, cough headaches, headaches associated with sexual activity, and hypnic headaches. The most crucial aspect for patients with headaches is identifying secondary headaches, which are related to brain or other systemic conditions (ear, nose, throat, teeth, or infectious diseases).

Red flag signs in headache patients include the onset after age 40, progressively worsening headaches, early morning onset, sudden onset, the presence of systemic illness (cancer, AIDS), changes in headache characteristics, headaches worsened by coughing, straining, or bending forward, headaches that improve when lying down but worsen upon standing, always occurring on the same side, and neurological or systemic findings on examination. In such cases, detailed and urgent investigations may be required.