Updated 2026-08-23intermediate

TOEFL Reading Practice #015 — The Headache That Isn't in Your Brain

Free TOEFL Reading practice: The Headache That Isn't in Your Brain. 11 questions with a full passage and answer key.

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How to use this practice: Read the passage once without a dictionary, then answer the questions on your own. Tap “Answer” under each question to reveal just the correct letter — no explanations, so you can keep testing yourself.
1

Passage

Read the full passage. Bracketed letters like [A] mark the four positions for the insert-text question.

The Headache That Isn't in Your Brain

¶1 Eating ice cream or drinking a very cold beverage too quickly can bring on a sharp, stabbing pain across the forehead within seconds. Most people call this brain freeze, a name that suggests the brain is reacting painfully to the cold. That explanation runs into a basic problem, however. The brain has no pain receptors of its own and cannot feel cold, heat, or pressure directly. Surgeons can even operate on brain tissue while a patient stays awake, and the patient reports no pain at all. If the brain cannot feel cold, something else must explain why cold food produces such a sudden, sharp pain in the head.

¶2 The true cause begins not in the brain but in the roof of the mouth. The soft palate and the back of the throat are lined with blood vessels that sit unusually close to the surface. When something very cold touches this area, those vessels react at once, narrowing sharply to limit how much cold reaches the tissue underneath. Within seconds, they swing the other way and widen rapidly, letting warm blood flood back in to protect the area. A nerve called the trigeminal nerve also carries feeling from the forehead and much of the face. It picks up this rapid change and sends a pain signal toward the brain.

¶3 The brain now has a strong pain signal to interpret, but it makes a specific kind of mistake in doing so. The trigeminal nerve carries signals from many parts of the face and mouth at once. [A] The brain cannot always sort out which branch a signal came from. [B] It tends to assume the signal is coming from wherever that nerve is felt most often, which for most people is the forehead. [C] Doctors call this kind of mix-up referred pain, meaning pain that is felt in a location different from where it actually began because the nerve pathways for the two areas cross or overlap. [D] The stabbing pain of brain freeze, in other words, is really a pain signal from the mouth and throat that gets mislabeled somewhere along the way.

¶4 Brain freeze looks like proof that cold can reach and hurt the brain directly. In fact, the brain is never actually involved in feeling the pain at all. The true event takes place in the mouth and throat, in blood vessels reacting to sudden cold. The brain simply reads the signal as if it came from the wrong place. This kind of mislabeling is not unique to brain freeze. The same mechanism explains other confusing pains too. One example is the arm pain some people feel during a heart attack, even though it is the heart itself that is damaged. So brain freeze is not a malfunction at all. It is a harmless side effect of a nervous system that usually, though not always, gets the location of pain exactly right.

  • soft palate: the front part of the roof of the mouth
  • trigeminal nerve: the nerve that carries feeling from the face, mouth, and forehead
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Questions

11 questions — every TOEFL Reading question type, in test order.

Q1 · Vocabulary
The phrase runs into in paragraph 1 ("That explanation runs into a basic problem, however.") is closest in meaning to
  1. A. encounters
  2. B. avoids
  3. C. resolves
  4. D. creates
Answer
Correct: A
Q2 · Reference
The word they in paragraph 2 ("Within seconds, they swing the other way and widen rapidly") refers to
  1. A. the trigeminal nerve
  2. B. the blood vessels
  3. C. the tissue underneath
  4. D. cold beverages
Answer
Correct: B
Q3 · Essential Term
Based on the information in the passage, the term referred pain can best be explained as
  1. A. the sharp pain that occurs when cold directly touches brain tissue
  2. B. pain that a doctor must confirm using medical tests
  3. C. pain that lasts longer the colder the food or drink is
  4. D. pain that is felt in a place different from where it actually begins, because the nerve pathways for the two areas cross
Answer
Correct: D
Q4 · Factual Information
According to paragraph 2, why do the blood vessels in the mouth and throat widen again a few seconds after narrowing?
  1. A. to let warm blood flow back in and protect the area
  2. B. to reduce the trigeminal nerve's sensitivity to cold
  3. C. to send the pain signal more quickly to the brain
  4. D. to prevent the throat muscles from swelling
Answer
Correct: A
Q5 · Negative Fact
According to paragraph 4, all of the following are true EXCEPT
  1. A. The brain is not actually involved in feeling the pain of brain freeze
  2. B. The actual physical event behind brain freeze takes place in the mouth and throat
  3. C. Brain freeze is described as a malfunction of the nervous system
  4. D. The same mechanism that causes brain freeze also explains the arm pain some people feel during a heart attack
Answer
Correct: C
Q6 · Sentence Simplification
Which of the sentences below best expresses the essential information in the highlighted sentence in paragraph 3? Incorrect choices change the meaning in important ways or leave out essential information.

Highlighted: "Doctors call this kind of mix-up referred pain, meaning pain that is felt in a location different from where it actually began because the nerve pathways for the two areas cross or overlap."
  1. A. Doctors call it referred pain because the pain begins in a different place from where the nerve pathways overlap
  2. B. Doctors use the term referred pain for pain that appears in a different place from where it began, because the nerve pathways of the two locations overlap
  3. C. Doctors call this referred pain, which means pain that spreads to more than one place at the same time
  4. D. Referred pain only happens when nerve pathways from two areas are permanently connected
Answer
Correct: B
Q7 · Inference
Based on the information in paragraphs 3 and 4, what can be inferred about the arm pain some people feel during a heart attack?
  1. A. It happens only in patients who have previously experienced brain freeze
  2. B. It occurs because the heart has no pain receptors, just like the brain
  3. C. It is a different, unrelated kind of pain that has nothing to do with referred pain
  4. D. It occurs because nerve pathways connecting the heart and the arm cross or overlap, so the brain misreads where the pain is coming from
Answer
Correct: D
Q8 · Rhetorical Purpose
The author mentions that surgeons can operate on brain tissue while a patient stays awake and reports no pain in order to
  1. A. support the claim that the brain has no pain receptors and cannot feel pain directly
  2. B. argue that brain surgery is safer than most people think
  3. C. explain a specific medical technique used during modern surgery
  4. D. introduce the concept of referred pain that appears later in the passage
Answer
Correct: A
Q9 · Paragraph Relation
How does paragraph 3 relate to paragraph 2?
  1. A. It shows that the vessel reaction described in paragraph 2 fails to explain the pain of brain freeze
  2. B. It explains what the brain does with the pain signal that paragraph 2 shows the vessels and nerve producing
  3. C. It simply repeats the description of blood vessels narrowing and widening that paragraph 2 already gave
  4. D. It describes a relationship between paragraph 1 and paragraph 4 rather than paragraph 2 and paragraph 3
Answer
Correct: B
Q10 · Insert Text
Look at the four squares [■] in paragraph 3 that indicate where the following sentence could be added.

That assumption is almost always wrong, but it happens too fast for the brain to double-check.

Where would the sentence best fit?
  1. A. Square A
  2. B. Square B
  3. C. Square C
  4. D. Square D
Answer
Correct: C
Q11 · Prose Summary Select THREE · 2 pts
Directions: An introductory sentence for a brief summary of the passage is provided below. Complete the summary by selecting the THREE answer choices that express the most important ideas in the passage. Some sentences do not belong in the summary because they express ideas that are not presented in the passage or are minor ideas in the passage. This question is worth 2 points.

The sudden forehead pain known as brain freeze feels like the brain itself reacting to cold, but the real explanation involves blood vessels, a nerve, and a case of mistaken location.

  1. A. Brain freeze feels like direct pain in the brain, but the brain has no pain receptors and cannot feel cold on its own
  2. B. Cold touching blood vessels in the mouth and throat makes them narrow and then widen quickly, and the trigeminal nerve detects this rapid change
  3. C. The brain assigns the resulting signal to the forehead instead of to its real source in the mouth and throat, a mix-up known as referred pain
  4. D. Surgeons can operate on brain tissue while a patient stays awake without causing any pain
  5. E. The same referred-pain mechanism also explains the arm pain some people feel during a heart attack
  6. F. Drinking cold beverages slowly instead of quickly prevents the vessels in the mouth from narrowing at all
Answer
Correct: A, B, C