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What Happens to the Brain When You Get a Headache?

author image Jennifer Markowitz, MD
Based outside Boston, Jennifer Markowitz received her M.D. from the University of Pennsylvania and completed residency training at the Children's Hospitals of Philadelphia and Boston. She is board-certified in Pediatric Neurology and Neuromuscular Medicine. Her writing and presentations have focused on both scientific and patient audiences.
What Happens to the Brain When You Get a Headache?
Woman with a headache holding her head Photo Credit: Jacob Wackerhausen/iStock/Getty Images

When you have a headache, you may wonder what is going on inside your brain. Brain tissue itself cannot feel pain. Instead, your brain processes pain sensations that it receives from the rest of the body. Depending on the type of headache you have, pain signals may come from nerves, blood vessels or membranes that surround the brain, or from muscles of the head and neck. Some headaches are also associated with electrical changes in brain activity.

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Muscle Tension

Woman holding her sore neck
Woman holding her sore neck Photo Credit: Rutchapong/iStock/Getty Images

Tension-type headaches are the most common variety. Dull, pressurelike pain on both sides of the head is typical, sometimes extending to the back of the head. Muscles of the head and neck might be tender. The cause of tension-type headache is not known, though some suggest that the pain originates from excess muscle tension. Pain-sensitive nerves within tense muscles carry these signals to the spinal cord and then to higher brain areas involved in touch, emotions and movement.

Brain Hyper-reactivity

Senior woman with a migraine clutching her head
Senior woman with a migraine clutching her head Photo Credit: KatarzynaBialasiewicz/iStock/Getty Images

Migraines cause throbbing pain on one side of the head, typically with other symptoms such as light and sound sensitivity, nausea and vomiting. Some people experience an aura before the headache, with symptoms like seeing flashing lights. A wave of electrical activity spreads across the brain during the aura. Migraine pain primarily involves the trigeminal and cervical nerves, which carry pain signals from the face, head and neck, and from the blood vessels and membranes around the brain. Pain signals from these nerves are amplified as they enter the brainstem, making them hypersensitive. This sets up a vicious cycle of worsening pain.

Increased Pressure

MRI brain scans on display
MRI brain scans on display Photo Credit: IvicaNS/iStock/Getty Images

Headaches may result from increased pressure inside the head. This can happen when a tumor or bleeding blocks the flow of cerebrospinal fluid, which surrounds and cushions the brain. Increased pressure can also be caused by brain swelling due to head trauma, stroke or infection. In all of these cases, pain results from stretching of blood vessels inside the head and is sensed by the trigeminal and cervical nerves. Headaches from increased intracranial pressure may be worse in the morning and associated with vomiting and blurry or double vision.

When to Seek Medical Attention

Man with nurse clutching his head
Man with nurse clutching his head Photo Credit: AlexRaths/iStock/Getty Images

Seek emergency medical attention if you have a headache that is sudden or severe, if you have a stiff neck or changes in your vision. See your doctor if you have a headache with nausea or vomiting, trouble with speech or swallowing, changes in sensation or problems walking.

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