Hello, Thanks for posting this question in HCM First of all let me tell you that a given medical problem can be due to various causes. Headache can be due to various causes too. It can be due to brain tumor, infection, problem in the blood vessels of brain, migraine and so on. Whether a patient with headache will require a brain scan largely depend upon the presence or absence of neurological deficit on neurological assessment by a neurologist. In view of long duration of hisotory, the diagnosis of your symptoms could be due to migraine. Regarding the management of migraine there are two steps 1. Treatment of the severe episodes: During severe episodes, one can use paracetamol, other analgesics, sumatriptan nasal spray (make sure that you don’t have heart problem, it cannot be used if you have) 2. Treatment in absence of headache: There are medicines which can alter the migraine in due course and these medicines are to be used for daily for 6months-1 year. The medicines available are valproate (not good for females due to weight gain, menstrual problem,), topiramate, amitriptiline, propranolol. 3. Identify the factor which aggravates the headache and try to avoid coffee and strees, sleep deprivation. Do relaxation. All these methods will decrease the severity of headache and prevent future episodes. The other possibility of short lasting headache could be cluster headache, though the diagnosis is difficult as per the listed symptoms. I advise you to get checked by a neurologist who will approach the way i have discussed. Note that you will certainly going to have improvement. Hope this will clarify