Migraine headaches typically last 4 to 72 hours but may be as brief as 20 or 30 minutes or last days or, rarely, weeks. The usual headache lasts less than 24 hours. A striking singular feature of migraine is the freedom from headache between prostrating attacks. The headaches of brain tumor are intermittent and vary in intensity but usually occur every day. Tension-type headache may persist for days, weeks, or even years.

Migraine headaches and headaches associated with hypertension frequently occur in the early morning hours, with the patient awakening in pain. Cluster headache commonly occurs after sleep onset. The headache of brain tumor may be more severe in the early part of the day, though not in the early hours of the morning, and may not have any diurnal pattern.

Migraine attacks are common during week-ends, during the first period of vacation holidays, and immediately after vacation. Attacks are commonly triggered by menstruation. Migraineurs often have their headaches on specific days of the week.

Migraine headache occurs during periods of increased conflict, tension, or stress for the individual, for example, during early fall for the schoolteacher, during rush or holiday seasons for the merchant, or during very hot or humid weather for those who feel ineffective and prostrated during such climatic states. Headache associated with nasal and paranasal disease is usually more common during periods when upper respiratory infections prevail, namely, the darker months of the year. Exacerbations of tic douloureux are common in the spring and fall, notably March and October. The same may be true for cluster headaches.

Headache - Prodromes and Auras
Significant prodromes, such as mood changes or changes in appetite, can occur 1 to 2 days before a migraine headache. Auras such as scintillating scotoma or paresthesias precede and define classic migraine.

Editors: Silberstein, Stephen D.; Lipton, Richard B.; Dalessio, Donald J.