The TV reporter had a bad headache. Just before her live spot, she realized that she couldn’t read her notes. On camera her smile was bright, but her words were gibberish and an anxious look crossed her face.

Viewers who knew the symptoms of stroke worried that she was having one. But medical tests found that her brain wasn’t damaged. She was having her first migraine.

Getting it checked out was the right thing to do because problems with speaking and some other symptoms of migraine, like numbness on one side of your body, can be symptoms of stroke.

Both migraine and stroke involve dramatic changes in blood flow in the brain. These symptoms should be treated as a medical emergency until stroke is ruled out and the person gets to know their own typical headache symptoms.

What are the different types of headaches?

Tension headaches are the most common. Tense muscles in the face, scalp and neck contribute to the pain. You have steady mild-to-moderate pain, tightness or pressure on both sides of your head and neck. It doesn’t get worse if you walk around, and it doesn’t cause nausea. It can last for less than an hour, or up to a week.

Migraine headaches are the second most common type. They start with nerve cell activity in the brain, which then affects blood flow. About 18% of women and 6% of men get migraines. Migraines come in phases, but not everyone has each phase.

Within the 24 hours before a migraine headache, some people have symptoms like diarrhea, fatigue, excess thirst or feeling depressed or irritable.

Often, 10-60 minutes before the headache, some people have symptoms called aura. You may:

  • See flashing or bright lights or heat waves
  • Have numb, weak or tingling sensations on one side of your body
  • Have trouble speaking
  • Have odd experiences in smell, taste or hearing
  • The headache usually starts with moderate to severe throbbing pain on one side of your head and gets worse. You might also have nausea, vomiting, blurred vision, confusion and extreme sensitivity to sound, odors or light. These symptoms may last from 4 to 72 hours and get worse if you move.

The tendency to have migraines is inherited. They’re more common in females, white people, poor people and those with depression, anxiety, obesity or epilepsy.

What triggers headaches?

Tension headache triggers include:

  • Stress, anxiety or depression
  • Fatigue
  • Hunger
  • Clenching your jaw or a poor bite
  • Arthritis in the neck
  • Drinking alcohol
  • Caffeine withdrawal or too much caffeine
  • Neck strain from poor posture or sitting too long in one position
  • Eye strain from poor lighting or computer use

Migraine triggers include:

  • Stress or strong emotion
  • Lack of sleep, too much sleep or change in sleep schedule
  • Skipping meals
  • Changes in the weather, altitude or hot or cold conditions
  • In women, hormone changes at puberty or during ovulation, periods, pregnancy or menopause
  • Intense physical exertion, including sexual activity
  • Bright or flashing lights, glare, fluorescent lights or computer screens
  • Certain foods, most commonly cheese, garlic, raw onions, citrus fruits, vinegar, pickled products, nuts, chocolate, the artificial sweetener aspartame or the food additives MSG (monosodium glutamate) or nitrates in processed meats
  • Red wine, beer or other alcoholic drinks
  • Caffeine or caffeine withdrawal

Medications often do little to dull the pain of a migraine but they can be completely effective for smaller headaches. For a nagging head pain that won’t quite leave, try a hot or cold shower and see which one works best for you.

For more severe headaches, turn off all overhead lighting and try to eliminate any environmental noise. One of the most effective forms of relief is to have a second person massage the neck and temples. These pressure points can allow for instant freedom from pain, though often it’s only temporary.

For the most severe of migraines, be sure to work with your doctor. Recurring migraines can take the enjoyment out of every day life but a good doctor will take your problem very seriously, work to find the triggers and treat them accordingly.

Living with headache pain should never be an acceptable part of every day life. If your doctor isn’t taking your pain seriously, it’s probably time to visit a specialist.