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Updated December 14, 2014.
Most of the time frontal headaches are caused by migraines or tension headaches. Rarely, they are secondary headaches--meaning they are caused by another underlying medical condition. In this case, there are often other clues, besides a headache, that help the doctor make the diagnosis. Here are examples of secondary headaches that can cause frontal head pain.
Giant Cell Arteritis
Giant cell arteritis or GCA is a large and medium blood vessel vasculitis.
Vasculitis refers to inflammation of blood vessels. GCA mostly affects the branches of the external carotid artery, a large artery in the neck. The inflammation of specific arteries in GCA impairs blood flow, causing various symptoms like headache, vision changes, and jaw pain when chewing.
The headache of giant cell arteritis classically occurs in the temples, either both or just one. It can also be localized to the forehead or even the back of the head. Or, it can be more generalized and occur "all over." Sometimes, people will say it hurts to brush their hair or put on a baseball cap.
There are usually other symptoms that hint at the diagnosis of GCA. You may have a fever or feel achy all over. This feeling and headache may be occurring on and off for weeks, even months. Vision changes, like a complete loss of vision in one eye or double vision, can occur with giant cell arteritis. It is sometimes this feared symptom that leads individuals to finally seek medical attention.
Brain Tumor
A brain tumor occurs when cells in the brain grow out of control and in an abnormal way. There are different types of brain cancer, and they grow at different rates, some slowly, and some rapidly. Usually, the pain of a brain tumor headache is dull and occurs all the time. Sometimes, it is throbbing.
Headaches from brain tumors are usually worse at night, and people will commonly report that the pain wakes them from their sleep. The headache often occurs or is worse on the same side as the tumor. But, the headache can also be generalized, especially if it is due to increased intracranial pressure (ICP) or hydrocephalus.
There may be other symptoms associated with a brain tumor besides headache. These include:
- Seizures
- Nausea and Vomiting
- Loss of Consciousness
- Memory Loss
- Mood Disturbances (i.e. Depression) and/or Personality Changes
- Muscle Weakness
- Difficulty with Language (i.e. slurred speech)
- Vision Problems
Cervicogenic Headache
A cervicogenic headache occurs when head pain is referred from the neck. This type of headache is usually one sided and can occur in the forehead region. If you have a cervicogenic headache, you will also likely have a reduced range of motion of your neck and notice onset or worsening of the pain with certain neck movements. You may also have same-sided shoulder or arm pain associated with the headache. Nausea, vomiting, photophobia (sensitivity to light), and phonophobia (sensitivity to sound) can occur with a cervicogenic headache.
The exact cause of this type of headache is still not clear, but it believed that the compression or irritation of the nerves in your upper neck are involved. Physical therapy is the mainstay treatment for a cervicogenic headache.
Take Home Message
Remember, frontal headaches are usually benign and not due to an alarming cause. The above examples are rare and can only be properly diagnosed by a healthcare provider. If you have headache alert signs or are just worried about a rather persistent headache, please seek medical attention so you can be properly assessed.
Sources
Biondi, D. Bajwa ZH. Cervicogenic Headache. In: UpToDate, Basow DS (Ed), UpToDate, Waltham, MA, 2013.
Calamia KT & Hunder GG. Giant cell arteritis (temporal arteritis) presenting as fever of undetermined origin. Arthritis Rheum. 1981 Nov;24(11):1414-8.
Gonzalez-Gay MA, Barros S, Lopez-Diaz MJ, Garcia-Porrua C, Sanchez-Andrade A, Llorca J. Giant cell arteritis: disease patterns of clinical presentation in a series of 240 patients. Medicine (Baltimore). 2005 Sep;84(5):269-76.
Headache Classification Subcommittee of the International Headache Society. "The International Classification of Headache Disorders: 2nd Edition". Cephalalgia 2004;24 Suppl 1:9-160.
Hunder GG, Bloch DA, Michael BA, Stevens MB, Arend WP, Calabrese LH et al. The American College of Rheumatology 1990 criteria for the classification of giant cell arteritis. Arthritis Rheum 1990;33(8):1122.
Seiden AM & Martin VT. Headache and the frontal sinus. Otolaryngologic Clinics of North America. 2001;34:997–1016.
Sjaastad O, Fredriksen TA, Pfaffenrath V. Cervicogenic headache: diagnostic criteria. The Cervicogenic Headache International Study Group. Headache. 1998;38:442.
Wong ET, Wu JK. Clinical presentation and diagnosis of brain tumors. In: UpToDate, Basow DS (Ed), UpToDate, Waltham, MA, 2013.
DISCLAIMER: The information in this site is for educational purposes only. It should not be used as a substitute for personal care by a licensed physician. Please see your doctor for diagnosis and treatment of any concerning symptoms or medical condition.
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