Secondary Headache Disorders

2021 ◽  
pp. 892-900
Author(s):  
Amaal J. Starling ◽  
David W. Dodick
Keyword(s):  
Primary Headache ◽  
Abrupt Onset ◽  
Severe Headache ◽  
Maximum Intensity ◽  
Thunderclap Headache ◽  
Secondary Headache ◽  
Headache Disorders ◽  
Primary Headache Disorders ◽  
Neurologic Emergency ◽  
Secondary Causes

In the evaluation of a patient with headache, the first task is to differentiate between a secondary headache and a primary headache. This step is essential because secondary causes of headache may require vastly different evaluation and treatment than primary headache disorders. Thunderclap headache (TCH) is an acute, severe headache with an abrupt onset, reaching maximum intensity in less than 1 minute. TCH is a neurologic emergency and should immediately prompt an urgent evaluation for a secondary headache.

scholarly journals Narrative Review of the Pathophysiology of Headaches and Photosensitivity in Mild Traumatic Brain Injury and Concussion

2018 ◽  
Vol 46 (1) ◽  
pp. 14-22 ◽  
Author(s):  
Christopher Mares ◽  
Jehane H. Dagher ◽  
Mona Harissi-Dagher
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Mild Traumatic Brain Injury ◽  
Primary Headache ◽  
Underlying Mechanism ◽  
Glutamate Excitotoxicity ◽  
Secondary Headache ◽  
Headache Disorders ◽  
Primary Headache Disorders ◽  
Post Traumatic

AbstractThe most common symptom of post-concussive syndrome (PCS) is post-traumatic headache (PTH) accompanied by photophobia. Post-traumatic headache is currently categorized as a secondary headache disorder with a clinical phenotype described by its main features and resembling one of the primary headache disorders: tension, migraine, migraine-like cluster. Although PTH is often treated with medication used for primary headache disorders, the underlying mechanism for PTH has yet to be elucidated. The goal of this narrative literature review is to determine the current level of knowledge of these PTHs and photophobia in mild traumatic brain injury (mTBI) in order to guide further research and attempt to discover the underlying mechanism to both symptoms. The ultimate purpose is to better understand the pathophysiology of these symptoms in order to provide better and more targeted care to afflicted patients. A review of the literature was conducted using the databases CINAHL, EMBASE, PubMed. All papers were screened for sections on pathophysiology of PTH or photophobia in mTBI patients. Our paper summarizes current hypotheses. Although the exact pathophysiology of PTH and photophobia in mTBI remains to be determined, we highlight several interesting findings and avenues for future research, including central and peripheral explanations for PTH, neuroinflammation, cortical spreading depolarization and the role of glutamate excitotoxicity. We discuss the possible neuroanatomical pathways for photophobia and hypothesize a possible common pathophysiological basis between PTH and photophobia.

Headache in Sports

2016 ◽  
Author(s):  
Tad Seifert
Keyword(s):  
Primary Headache ◽  
Headache Disorder ◽  
Epidemiological Data ◽  
Return To Play ◽  
Secondary Headache ◽  
Headache Disorders ◽  
Unique Challenge ◽  
Primary Headache Disorder ◽  
Primary Headache Disorders ◽  
Headache Type

The prevalence of primary headache disorders in the general population provides a unique challenge in the evaluation of headache occurring in the context of sport. Sport-related and exercise-related headaches are not uncommon, but there is limited epidemiological data on these types of headaches in athletes. Any primary headache type can occur in the setting of sports. These scenarios are challenging in the return to play context, as it is often unclear whether an athlete has an exacerbation of a primary headache disorder, new onset headache unrelated to trauma, or has suffered a genuine concussive injury. Through careful evaluation, the practitioner can distinguish primary headache disorders from posttraumatic headaches following concussion. This chapter reviews primary headache disorders, posttraumatic headaches, and other secondary headache disorders.

scholarly journals Revised 2004 International Classification of Headache Disorders: New Headache Types

2004 ◽  
Vol 31 (3) ◽  
pp. 304-314 ◽  
Author(s):  
Jonathan P. Gladstone ◽  
David W. Dodick
Keyword(s):  
Treatment Guidelines ◽  
International Headache Society ◽  
Genetic Research ◽  
Primary Headache ◽  
Current Treatment ◽  
International Classification ◽  
Secondary Headache ◽  
Headache Disorders ◽  
Primary Headache Disorders

In 1988, the International Headache Society created a classification system that has become the standard for headache diagnosis and research. The International Classification of Headache Disorders galvanized the headache community and stimulated nosologic, epidemiologic, pathophysiologic, and genetic research. It also facilitated multinational clinical drug trials that have led to the basis of current treatment guidelines. While there have been criticisms, the classification received widespread support by headache societies around the globe. Fifteen years later, the International Headache Society released the revised and expanded International Classification of Headache Disorders second edition. The unprecedented and rapid advances in the field of headache led to the inclusion of many new primary and secondary headache disorders in the revised classification. Using illustrative cases, this review highlights 10 important new headache types that have been added to the second edition. It is important for neurologists to familiarize themselves with the diagnostic criteria for the frequently encountered primary headache disorders and to be able to access the classification (www.i-h-s.org) for the less commonly encountered or diagnostically challenging presentations of headache and facial pain.

Headache

2016 ◽  
pp. 355-382
Author(s):  
Douglas J. Gelb
Keyword(s):  
Primary Headache ◽  
Secondary Headache ◽  
Headache Disorders ◽  
Primary Headache Disorders ◽  
Secondary Headache Disorders ◽  
Tacit Assumption ◽  
Migraine Headaches ◽  
Pathophysiologic Mechanisms

Headaches can occur independently of any other disease processes (primary headache disorders) or they can be associated with a wide variety of underlying neurologic and systemic conditions (secondary headache disorders). The pathophysiologic mechanisms are incompletely under- stood. Most research has focused on migraine headaches, with the tacit assumption that other headache syndromes, both primary and secondary, have similar mechanisms.

Chronic migraine and medication overuse headache

2020 ◽  
pp. 275-283
Author(s):  
David W. Dodick ◽  
Stephen D. Silberstein
Keyword(s):  
Subarachnoid Haemorrhage ◽  
Chronic Migraine ◽  
Cerebral Aneurysm ◽  
Medication Overuse Headache ◽  
Abrupt Onset ◽  
Severe Headache ◽  
Thunderclap Headache ◽  
Work Up ◽  
Neurologically Intact ◽  
Secondary Causes

Thunderclap headache refers to the abrupt onset of a severe headache. Characteristics of the pain are not strictly defined, but intensity is considered to peak in seconds to a minute. This chapter focuses on the work-up of alert neurologically intact patients presenting with an acute and severe headache, not related to trauma. Work-up to detect or exclude a subarachnoid haemorrhage is described first, followed by an overview of investigations to detect a cerebral aneurysm. Thereafter, other secondary causes of thunderclap headache and their suitable analysis will be discussed, followed by a brief overview of primary thunderclap headaches.

scholarly journals Characteristics of headache attributed to COVID-19 infection and predictors of its frequency and intensity: A cross sectional study

Cephalalgia ◽  
2020 ◽  
Vol 40 (13) ◽  
pp. 1422-1431 ◽  
Author(s):  
Rehab Magdy ◽  
Mona Hussein ◽  
Christine Ragaie ◽  
Hoda M Abdel-Hamid ◽  
Ahmed Khallaf ◽  
...  
Keyword(s):  
Healthcare Providers ◽  
Primary Headache ◽  
Cross Sectional Study ◽  
Secondary Headache ◽  
Median Frequency ◽  
Sectional Study ◽  
Headache Disorders ◽  
Cross Sectional ◽  
Reactive Protein ◽  
Primary Headache Disorders

Objective To study the characteristics of headache attributed to COVID-19 infection and predictors of its severity. Methods A cross-sectional study involved 172 individuals who had headache due to COVID-19 infection. A detailed analysis of such headache was done through a face-to-face interview. Patients with any other form of secondary headache were excluded. Labs, including lymphocytic count, C-reactive protein, D-dimer and ferritin and chest imaging, were made available. Results: The majority of our patients had a diffuse headache (52.9%). It was pressing in 40.7%, with median intensity of 7 (assessed by visual analogue scale) and median frequency of 7 days/week. Patients with preexisting primary headache (52.9%) had significantly more frequent COVID-19 related headache than those without (47.1%) ( p = 0.001). Dehydrated patients (64.5%) had more frequent COVID-19 related headache than those who were not dehydrated (35.5%) ( p = 0.029). Patients with fever (69.8%) had significantly higher frequency and intensity of COVID-19 related headache compared to those without fever (30.2%) ( p = 0.003, 0.012). Patients with comorbidities (19.8%) had significantly higher frequency and intensity of headache than those without comorbidities (80.2%) ( p = 0.006, 0.003). After multiple linear regression, primary headache disorders, dehydration and comorbidities were considered predictors of frequency of COVID-19 related headache. Meanwhile, fever and dehydration were predictors of pain intensity. Conclusion Healthcare providers of COVID-19 patients need to be aware of frequency and intensity predictors of COVID-19 related headache: Primary headache disorders, fever, dehydration, and comorbidities.

Headache and rhinosinusitis: A review

Cephalalgia ◽  
2020 ◽  
pp. 033310242095979
Author(s):  
Claire EJ Ceriani ◽  
Stephen D Silberstein
Keyword(s):  
Differential Diagnosis ◽  
Primary Headache ◽  
Current Understanding ◽  
Secondary Headache ◽  
Headache Disorders ◽  
Sinus Disease ◽  
Primary Headache Disorders ◽  
Headache Relief

Purpose of review To explain our current understanding of headache attributed to rhinosinusitis, an often inappropriately diagnosed secondary headache. Recent findings Recent studies have shown that headache attributed to rhinosinusitis is often over-diagnosed in patients who actually have primary headache disorders, most commonly migraine. Failure to recognize and treat rhinosinusitis, however, can have devastating consequences. Abnormalities of the sinuses may also be treatable by surgical means, which may provide headache relief in appropriately selected patients. Summary It is important for the practicing physician to understand how rhinosinusitis fits into the differential diagnosis of headache, both to avoid overdiagnosis in patients with primary headache, and to avoid underdiagnosis in patients with serious sinus disease.

scholarly journals Clinical availability of SNOOP4 in acute non-traumatic headache patients admitted to the emergency department

2020 ◽  
pp. 102490792092868
Author(s):  
Wachira Wongtanasarasin ◽  
Borwon Wittayachamnankul
Keyword(s):  
Emergency Department ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Primary Headache ◽  
Tertiary Hospital ◽  
Adult Patients ◽  
Secondary Headache ◽  
Headache Disorders ◽  
Primary Headache Disorders ◽  
Sensitivity Specificity

Objectives: Non-traumatic headache accounts for up to 4.5% of all patients presenting to the emergency department. Non-traumatic headache is generally classified into two categories: primary and secondary headache disorders. Differentiating secondary from primary headache disorders is essential. SNOOP4 is known as a mnemonic for suggesting clinicians send neuroimaging to rule out serious conditions. Yet, the benefit of using this mnemonic in the emergency department is not well established. This study aimed to assess the significance of SNOOP4 in detecting serious causes of non-traumatic headache in adults presenting to the emergency department. Methods: We conducted a prospective observational study of adult patients presenting to the emergency department of the single tertiary hospital over a period of 12 months. Patients with acute non-traumatic headache presented at the emergency department were included. A standard record form was used. Patients were investigated and treated following the pre-existing protocols. Results were interpreted by attending radiologists. Each factor, according to SNOOP4, was then evaluated for the ability to predict serious causes of non-traumatic headache. Results: A total of 90 patients were included in this study with complete details obtained on 83 (92.2%) patients. Of these, 63 (75.9%) were female. The mean age was 44.5 years (inter-quartile range: 27–58.5). The duration of the headache ranged from 10 min to 7 days. Out of 83, 27 (32.5%) had at least one SNOOP4 criterion. In all, 25 patients (30.1%) underwent neuroimaging. The sensitivity, specificity, positive predictive value, and negative predictive value of SNOOP4 were 77.8%, 73.0%, 25.9%, and 96.4% respectively. Conclusion: SNOOP4 criteria show very high negative predictive value for excluding serious causes of acute non-traumatic headache in adult patients presenting to the emergency department.

Management of thunderclap headache in the emergency room: A retrospective cohort study

Cephalalgia ◽  
2021 ◽  
pp. 033310242098172
Author(s):  
David García-Azorín ◽  
Nuria González-García ◽  
Jaime Abelaira-Freire ◽  
Alberto Marcos-Dolado ◽  
Ángel Luis Guerrero ◽  
...  
Keyword(s):  
Cohort Study ◽  
Emergency Room ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Primary Headache ◽  
Final Diagnosis ◽  
Thunderclap Headache ◽  
Secondary Headache ◽  
Headache Disorders ◽  
Eligibility Criteria

Introduction The evaluation of red flags is crucial for the accurate the diagnosis of headache disorders, especially for thunderclap headache. We analysed if secondary headache disorders were adequately ruled out in patients that presented to the emergency room with thunderclap headache. Methods In this retrospective cohort study, we screened all patients that visited the emergency room for headache, including those that described thunderclap headache. We measured the frequency with which secondary causes were not adequately ruled out. We analysed the order of the exams, the final diagnosis, and the time elapsed between arrival, initial request for imaging, and the completion of the imaging. Results We screened 2132 patients, and 42 (1.9%) fulfilled eligibility criteria. Mean age was 43.1 ± 17.1 years, and 57% of patients were female. For 22 (52.4%) patients, the work-up was incomplete. Vascular study was missing in 16 (38.1%) patients, cerebrospinal fluid evaluation in nine (21.4%), and magnetic resonance imaging in seven (16.7%), with multiple assessments missing in six (14.3%). There were ten different combinations in which the exams were performed, with the most frequent being the second exam’s cerebral spinal fluid evaluation in 18 (52.9%) and the computed tomography angiogram in 10 (29.4%). A secondary cause of thunderclap headache was found in 16 (38.1%) patients, and four (9.5%) had a primary headache diagnosis after an adequate and complete study. Conclusions Thunderclap onset was described in one of every 50 patients that visited the emergency room for headache. More than half of these patients were not adequately managed. More than a third of thunderclap headache patients had a secondary cause.

scholarly journals Gambaran nyeri kepala pada mahasiswa pemain game komputer di Fakultas Kedokteran Universitas Sam Ratulangi angkatan 2012

e-CliniC ◽  
2016 ◽  
Vol 4 (1) ◽  
Author(s):  
Andre Alexander Rori ◽  
Melke J. Tumboimbela ◽  
Mieke A.H.N Kembuan
Keyword(s):  
University Students ◽  
Computer Games ◽  
Computer Game ◽  
Sampling Technique ◽  
Primary Headache ◽  
Secondary Headache ◽  
Headache Disorders ◽  
Cross Sectional ◽  
Probability Sampling ◽  
Primary Headache Disorders

Abstract: Headache or cephalalgia is a sensation of pain on the head to neck. Headache is divided into primary headache disorders and secondary headache disorders. Playing computer games is one of the university students’ usual activities. However, it can be a risk factor contributor for both types of headache. This study aimed to obtain the headache patterns and representations among university students who played computer games. This was a descriptive study with a cross-sectional design using questionairre . The sampling technique used was non-probability sampling with N=50. Data were analyzed by using frequency tables and cross tabulations. The results showed that there were 44 university students (88%) experienced headache while playing or at the moment after playing computer game. Mild pain level was the most experienced symptom, as many as 28 university students (56%). The patterns and other headache symptoms were categorized in tension-type (60%), migraine (28%), and no headache (12%). Keywords: headache, computer gamer, university student. Abstrak: Nyeri kepala atau cephalalgia adalah sensasi nyeri di bagian kepala hingga batas leher. Nyeri kepala terbagi atas nyeri kepala primer dan nyeri kepala sekunder. Bermain game komputer merupakan salah satu aktivitas yang sering dilakukan mahasiswa dan dapat menjadi kontributor faktor risiko terjadinya kedua tipe nyeri kepala tersebut. Penelitian ini bertujuan untuk mengetahui gambaran nyeri kepala pada mahasiswa pemain game komputer. Jenis penelitian ini ialah deskriptif dengan desain potong lintang menggunakan kuesioner. Teknik sampling yang digunakan ialah non-probability sampling yaitu consecutive sampling dengan N=50. Data dianalisis menggunakan tabel frekuensi dan cross tabulation. Hasil penelitian memperlihatkan 44 mahasiswa (88%) mengalami nyeri kepala selama atau sesaat setelah bermain game komputer. Derajat nyeri ringan merupakan yang paling banyak dialami, yaitu dialami oleh 28 mahasiswa (56%). Gambaran dan gejala nyeri kepala lainnya dikelompokkan dan mengarah ke nyeri kepala tipe tensi sebanyak 60%, tipe migraine 28%, dan sisanya 12% tidak nyeri kepalaKata kunci: nyeri kepala, pemain game komputer, mahasiswa

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