Headache temples or both sides of the Head? Here's a list of causes.

You searched for "headache temples", which I take to mean you may want to know the causes of a headache on both sides of the head.

Here's a list of possible causes, starting with the most common.  If you are struggling to cope with severe headaches you seriously think about following 'The Headache Friendly Lifestyle'.

  1. Tension headache

    Easily the most common cause, but not one that makes you go and see a doctor.

    You might want to try and massage away the pain in the temples, or take some paracetamol or aspirin.

    Can last a few hours, or if you are unlucky you can have the chronic form that just goes on for months or years.

  2. Migraine

    Migraine is the most common reason for people who search for "headache temples" i.e. both sides of the head that gets bad enough for you to want to go and see your doctor.

    Migraine can be subtle. If there are temple pains with nausea, worsening with movement or occasionally is bad enough to make you want to lie down, then treating these episodes of headache as migraine is more likely to work.

    About 50% of people with migraine do not realise they have it, so do not get effective treatment. Having said that a big part of migraine headache treatment is to live a headache friendly lifestyle!

  3. Systemic Illness Headache

    Pain on both sides of the head due to infection has not been very well recorded or researched.

    This is surprising as almost everybody who gets influenza (the Flu) will have a fairly significant headache. In the flu the headache can be at the front or be a "headache temples"!

    Most people with this will have an infection elsewhere in the body. The classic infections with a high incidence of systemic illness headache are:

    • Influenza
    • Lyme Disease
    • Brucellosis
    • Mycoplasma pneumoniae infection
    • Legionaire's Disease
    • Ehrlichia canis infection
    • Rocky Mountain Spotted Fever
    • Meditteranean Spotted Fever)
    • Leptospirosis (Weils Disease)
    • Dengue Fever

    Usually anyone who has one of these infections will have a fever and "look ill" - i.e. these are symptoms that would be very difficult to conceal - people will know you are unwell. Most of these require urgent medical attention.

  4. Thyroid Headache

    An underactive thyroid can cause a new onset headache that resolves when your thyroid hormone level returns back to normal. It can be a non-descript pain in the sides of the head ie a "headache temples".

  5. Phaeochromocytoma Headache

    Most people with this condition will get episodes of severe migraine-like headache affecting both sides of the head. It has a pulsating or bursting or throbbing character and each episode lasts anywhere between 5 and 120 minutes.

    The symptoms are due to a tumour (usually of the adrenal gland) that makes too much adrenaline and causes a sharp rise in blood pressure, pallor and sweating as well as the headache.

    If you have normal blood pressure it is very unlikely that you have this condition.

    However, it is a potentially serious cause if you have repeated episodes of a "headache temples".

  6. Cold-stimulus Headache

    Brain-freeze is usually felt at its worst in the both temples a cold-induced "headache temples"! People with migraine are much more likely to get these headache in the temples when there is a cold stimulus like eating ice-cream or ice.

  7. Sleep Deprivation Headache

    When a number of health professionals were interviewed about sleep deprivation in the late 1980s, many described a headache as part of the syndrome of sleep deprivation.

    This headache is usually across the front of the head, but pain in the temples is described. The pain is usually dull in nature, and is prevented by making sure you get a full night's sleep.

  8. Dialysis Headache

    Dialysis related headache has been known about since the 1970s. It is usually both sides of the head (headache temples) and is throbbing. It usually lasts for about 4 hours after a dialysis session.

    It seems to be related to a fall in blood pressure during dialysis, but the exact mechanism is unknown.

  9. Headache due to a change in the environment

    • Carbon Monoxide Poisoning

      Usually this headache affects both sides of the head. Carbon Monoxide poisoning is a life-threatening headache. It should be considered in new onset headaches presenting to emergency medical services.

    • Fasting Headache

      24 hour fasts are common as part of religious observance. A study in the 1990s of fasting identified a 39% risk of headache during a fast. The headache is usually in both temples and pressure-type instead of throbbing.

    • High Altitude Headache

      Climbing to high altitude (>4000m) will cause a headache in a large number of people. The pain is usually in both sides of the the head, and in about 40% will be worse on exertion and relieved by rest.

      It is usually throbbing or pulsing in quality. It is probably due to an increase of pressure within the skull. About a third of people with this headache will feel depressed or anxious during high altitude headache.

    • Air Flight Headache

      About 20% of people who fly will develop a headache during or following a flight. About 4% of people will always get a headache when they travel by air.

      The pain is usually a pressure feeling on both sides of the head, and lasts several hours. This "headache temples"can develop in people with no history of previous headaches.

      People with a previous history of headache may have a more migraine-like headache following air travel which is on one side of the head, and can have nausea or a throbbing quality to the pain.

      In the largest study of air travel headache, people were observed on descent to the level of the Dead Sea, and also on ascent to high altitude.

      Headache was much more likely on ascent to high altitude than on flying down to 400m below sea level. So the headache may be due to the slightly lower levels of oxygen that exist in airplane passenger areas.

  10. Disorders of pressure within the head

    • Intracranial Hypotension

      The typical low pressure headache is in both temples - "A Headache Temples". It is dull and moderate to severe in intensity.It is worse when up and about, but within 15 to 30 minutes (sometimes just 20-30 seconds) of lying flat (completely horizontal) the pain resolves.

      When pressure is low in the head hearing is often affected. This can be a muffled quality to sounds, or a hissing or buzzing noise in the ears.

      This condition requires specialised tests and can be treated with an epidural blood patch. Most cases, I think, are probably self-limiting and resolve themselves over a few weeks.

      It is thought that the most severe form of this condition occurs in about 50 people per million each year - so it is rare.

    • Idiopathic Intracranial Hypertension

      This condition can also cause pain on both sides of the head.High pressure in the head is made worse by lying flat, and the most comfortable position is to lie reclined, with pillows propping you up at an angle of 45 degrees.

      A pulsing or whooshing noise in the head in time to your pulse, called pulsatile tinnitus, is a good clue to the diagnosis.

      Being overweight makes you at an increased risk of this condition, and the mainstay of treatment is a weight reduction diet aiming for a Body Mass Index of 25 or less.

      This condition requires specialist investigation and follow-up.

Please remember that this page is my opinion and not an absolutely definitive list. However it is what I would consider to be a reasonable list of headache diagnoses to consider in some one with severe headaches who has searched for information on "headache temples".

Links on this site

Enough about "Headache Temples" - read more about the Location of Headache and how it can help make a diagnosis.

The Severe Headache Expert Home Page links from here.

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