Difference between tension or migraine headache

Dear Ask The Doctor: I'm teenager and I get a terrible headache like pricking my head with thorns and pressing it forward from both sides of my head. Sometimes I get light headed feeling.(fainting perhaps)Is this headache a tension headache or a migraine? Please please answer.

Dear Sanipa: It is sometimes difficult to tell the difference between the two. Tension headache as the name suggests is caused by stress, decreased calorie intake, and alcohol. It is caused by increased muscle tension of the scalp and neck causing pain. Whereas migraines may be caused by a chemical changes in the brain leading to decreased seratonin and dilatation of vessels in the brain. Tension headaches are probably more common and is usually described as a band like pressure around the head whereas migraines on the other hand tend to to be located on one side of the head and can present with aura (light flashes, nausea). Your symptoms are most probably due to a tension headache. General management of both these headaches are similar which consist of NSAIDs (motrin or advil), rest, ice packs or a long, hot shower.