Chart — Neurology
Primary Headache Comparison Chart
Three benign headaches with very different signatures: migraine (throbbing, one-sided, nausea/aura), tension (band-like, both sides), and cluster (one eye, tearing, treated with oxygen).
Educational use only. Always rule out dangerous secondary headaches first. Treatment is provider-directed. This chart is an educational comparison aid. This material supports nursing education and exam review. It is not medical advice and is not a substitute for clinical judgment, institutional policy, or medical direction. Always follow facility protocols and current provider orders.
Migraine vs Tension vs Cluster
| Feature | Migraine | Tension-type | Cluster |
|---|---|---|---|
| Location/quality | Usually unilateral, throbbing/pulsating | Bilateral, band-like, pressing/tightening | Unilateral, around/behind one eye, boring/excruciating |
| Duration | 4–72 hours | 30 min–7 days | 15 min–3 hours, in clusters (often same time daily) |
| Associated features | Nausea, photophobia/phonophobia, ± aura | Few; no nausea/aura | Ipsilateral tearing, nasal congestion, ptosis; restlessness |
| Typical patient | Women > men; family history | Very common; stress-related | Men > women |
| Treatment | Triptans/NSAIDs (abortive); preventives if frequent | NSAIDs/acetaminophen; stress management | High-flow oxygen + triptans; preventives |
Exam Traps
- ✦Migraine = unilateral throbbing + nausea + photophobia (± aura); tension = bilateral band-like.
- ✦Cluster = unilateral peri-orbital pain with tearing/congestion, in clusters → treat with HIGH-FLOW OXYGEN.
- ✦Take abortive therapy (triptans/NSAIDs) EARLY in the attack.
- ✦Migraine WITH aura + estrogen contraceptives = stroke risk — avoid.
- ✦Always screen for SNOOP red flags before labeling a headache 'primary.'
Related Resources
Standards & sources
Fact-checked Jun 21, 2026This page is written to align with American Heart Association / American Stroke Association (AHA/ASA) · American Association of Neuroscience Nurses (AANN). It is an educational summary, not a citation of any single document — always verify specific doses, values, and protocols against current guidelines and your facility policy. How we source content →