A Practical Approach to Headache Treatment

2007 ◽  
Vol 20 (2) ◽  
pp. 123-136
Author(s):  
Tarvez Tucker
Keyword(s):  
Health Care Providers ◽  
International Headache Society ◽  
Medication Overuse Headache ◽  
Primary Headache ◽  
Tension Type Headache ◽  
Warning Signs ◽  
World Health ◽  
Primary Headaches ◽  
Care Providers ◽  
Primary Headache Disorders

The World Health Organization cites migraine headache as one of the 20 most disabling medical conditions. This article focuses on the diagnosis and treatment of the primary headache disorders, with special emphasis on migraine, the headache most likely to bring patients to physicians and pharmacists. This review begins with the warning signs of the ominous headache, which, although rare, can herald a life-threatening condition. Clinical characteristics of the primary headache types, migraine, tension-type headache, and cluster headache, are described. Although many individuals believe their headaches are “sinus,” or “stress or tension-induced,” most of the characteristics of these types of headaches actually meet International Headache Society criteria for migraine. Treatments of primary headaches, including acute therapies, abortive agents, and prophylactic medications, are uniquely specific for each headache syndrome. Chronic daily headache patients compose only 4% of the population yet make up the largest percentage of patients who seek treatment at specialty headache centers. Medication-overuse headache, the syndrome in which medications taken for the relief of headache actually foster future headaches, offers a particular challenge to health care providers, as does narcotic use in headache therapy. Complementary and alternative treatments proven efficacious in the treatment of primary headache are also described.

Diagnosis and Clinical Management of Headaches

CNS Spectrums ◽  
1999 ◽  
Vol 4 (9) ◽  
pp. 32-37
Author(s):  
Daniel P. Greenfield ◽  
Subramanian Hariharan
Keyword(s):  
Clinical Management ◽  
International Headache Society ◽  
Brain Lesion ◽  
Pain Syndrome ◽  
Primary Headache ◽  
Tension Type Headache ◽  
Primary Headaches ◽  
Primary Headache Disorders ◽  
Primary Disorder ◽  
Type Headache

AbstractIn this article, we will first present an overview of the epidemiology and classification of headaches, distinguishing between primary headaches (in which the headache itself is the primary disorder) and secondary headaches (ie, headaches due to an underlying condition, such as a neoplastic and/or space-occupying lesion, a cerebrovascular accident, or other type of structural brain lesion). We will use the current classification system of the International Headache Society, focusing on primary headache disorders (migraine, tension-type headache, cluster headache), which we will discuss from the practical clinical perspectives of diagnosis and clinical management. Throughout this article, we will emphasize the chronicity and periodicity of headaches as a type of chronic pain syndrome.

Prevalence of Primary Headache Disorders in Kuwait

2017 ◽  
Vol 48 (3-4) ◽  
pp. 138-146 ◽  
Author(s):  
Jasem Yousef Al-Hashel ◽  
Samar Farouk Ahmed ◽  
Raed Alroughani
Keyword(s):  
Medication Overuse Headache ◽  
Primary Headache ◽  
Headache Disorder ◽  
Episodic Migraine ◽  
Tension Type Headache ◽  
Primary Headaches ◽  
Primary Headache Disorder ◽  
Work Related ◽  
Primary Headache Disorders ◽  
Kuwaiti Population

Background: Only an insignificant quantum of data exists on the prevalence of primary headaches among those living in Kuwait. We aimed to determine the prevalence of primary headaches among the Kuwaiti population. Methods: This community-based study included Kuwaiti population aged 18-65 years. Using systematic random sampling, data was collected by the Headache-Attributed Restriction, Disability, Social Handicap and Impaired Participation questionnaire. Responses to the diagnostic questions were transformed into diagnoses algorithmically to confirm the diagnosis of primary headache. Results: A total of 15,523 patients were identified of whom 9,527 (61%) were diagnosed with primary headache disorder; a female predominance of 62.2% was observed. The mean age was 34.84 ± 10.19. Tension-type headache (TTH) was the most prevalent at 29% followed by episodic migraine (23.11%), chronic migraine (5.4%), and medication overuse headache (2.4%). Primary headache prevalence declined steadily from 71% in those aged 18-30 years to 23% in those over 50 (p < 0. 037). The female:male ratio was 1.7:1. Frequency and severity of primary headache were correlated significantly with lost work days (r = 0.611, p < 0.001 and r = 0.102, p = 0.001, respectively). Conclusions. In Kuwait, primary headache disorder is more frequent in young adults and females. TTH followed by episodic migraine were the more prevalent types of headache. Higher frequency and severe headaches were associated with increasing social and work-related burden.

The first prevalence study of primary headaches in adults in a post-conflict area of Serbia

Cephalalgia ◽  
2021 ◽  
pp. 033310242110060
Author(s):  
Nenad Milošević ◽  
Jasna Zidverc Trajković ◽  
Milija Mijajlović ◽  
Jovana Milošević ◽  
Ana Podgorac ◽  
...  
Keyword(s):  
Medication Overuse Headache ◽  
Primary Headache ◽  
Tension Type Headache ◽  
Primary Headaches ◽  
Headache Disorders ◽  
Cross Sectional ◽  
Primary Headache Disorders ◽  
Conflict Area ◽  
Post Conflict ◽  
Type Headache

Aim The aim of the present study was to establish annual prevalence of primary headaches, migraine, and tension-type headache among adults in a post-conflict area of Serbia. Methods The data for this cross-sectional study was obtained via face-to-face interviews using questionnaires specifically designed for this purpose, in line with the available guidelines. The study sample included adults aged 18–65 years whose native language is Serbian with residence in six predominantly Serbian communities in Kosovo and Metohija. Relevant diagnoses were established according to the diagnostic criteria of the International Classification of Headache Disorders, 3rd edition. Results The study included 1062 adults. Analyses indicated 47.7% prevalence of primary headaches. The 1-year prevalence of migraine (with aura and without aura) and tension-type headache was established at 15.2% (3.3% and 11.9%), and 32.2%, respectively. One-year prevalence of chronic headache was calculated at 3.5%, while the prevalence of medication overuse headache was slightly lower at 2.9%. Primary headaches were more prevalent among women, participants residing south of the river Ibar, married or cohabiting individuals, as well as among interviewees (persons) who reported feeling unsafe in Kosovo and Metohija. This is the first study of the prevalence of primary headache disorders in Serbia. The obtained data is comparable to the data available for other countries, especially those in the Balkan region.

Headache

2018 ◽  
Author(s):  
Benjamin W Friedman
Keyword(s):  
Differential Diagnosis ◽  
Clinical Characteristics ◽  
Sinus Thrombosis ◽  
International Headache Society ◽  
Primary Headache ◽  
Primary Headaches ◽  
Key Words Migraine ◽  
Secondary Headaches ◽  
Primary Headache Disorders ◽  
Greater Occipital Nerve

Headaches are one of the most common complaints of patients seen by emergency physicians. They can be classified as primary headaches, which have no identifiable underlying cause, and secondary headaches, which are classified according to their cause. The majority of headaches are benign in origin, and most patients with headache can be treated successfully in the emergency department and discharged home; however, some have potentially life-threatening causes, and consideration of a broad differential diagnosis for all patients is essential. This review covers the primary headache disorders, pathophysiology, stabilization and assessment, diagnosis and treatment, and disposition and outcomes. The figure shows areas of the brain sensitive to pain. Tables review differential diagnosis of headache, International Headache Society primary headache criteria, clinical characteristics of secondary headaches, high-risk clinical characteristics among patients with a headache peaking in intensity within 1 hour, drugs associated with headache, and parenteral treatment of acute migraine. This review contains 1 figure, 9 tables, and 58 references. Key words: migraine, calcitonin gene related peptide, greater occipital nerve block, venous sinus thrombosis, reversible cerebral vasoconstriction syndrome, Ottawa, subarachnoid, cluster headache, trigeminal autonomic cephalalgias, post-traumatic headache

Headaches

2021 ◽  
pp. 329-342
Author(s):  
Andrew D. Hershey
Keyword(s):  
Early Recognition ◽  
Primary Headache ◽  
Primary Care Providers ◽  
School Nurses ◽  
Primary Headaches ◽  
Care Providers ◽  
Primary Headache Disorders ◽  
Tension Type Headaches ◽  
The Impact

This chapter discusses recurrent headaches, especially when episodic, which are much more likely to represent primary headache disorders. Primary headaches are intrinsic to the nervous system and are the disease itself. Early recognition of the primary headaches in patients should result in improved response and outcome, minimizing the impact of the primary headaches and disability. Primary headaches can be grouped into migraine, tension-type headaches, and trigeminal autonomic cephalalgia, and an additional grouping of rarer headaches without a secondary cause. The primary headache that has the greatest impact on a child’s quality of life and disability is migraine, and subsequently is the most frequent primary headache brought to the attention of parents, primary care providers, and school nurses.

Headache Prevalence Among Adolescents — The German DMKG Headache Study

Cephalalgia ◽  
2007 ◽  
Vol 27 (4) ◽  
pp. 347-354 ◽  
Author(s):  
K Fendrich ◽  
M Vennemann ◽  
V Pfaffenrath ◽  
S Evers ◽  
A May ◽  
...  
Keyword(s):  
International Headache Society ◽  
Primary Headache ◽  
Population Based ◽  
Cross Sectional Study ◽  
Tension Type Headache ◽  
Cross Sectional ◽  
Primary Headache Disorders ◽  
Ihs Criteria ◽  
Probable Migraine ◽  
Type Headache

This population-based cross-sectional study examined the 3-month prevalence of headache, migraine and tension-type headache (TTH) among adolescents aged 12-15 years in Germany Students ( n = 3324) from 20 schools completed a questionnaire on general and headache-specific pain which included a sociodemographic module. The headache-specific questionnaire complied with the respective revised criteria of the International Headache Society (IHS). 'Modified criteria' changed the item 'duration' in migraine (>30 min instead of >4 h). The overall 3-month prevalence of headache was 69.4% (boys 59.5%, girls 78.9%), with 4.4% of the adolescents suffering from frequent (≥ 14 days/3 months) and severe (grade 8-10 on a 10-point visual analogue scale) headache and 1.4% (boys 0.9%, girls 1.9%) from headache ≥15 days/month. The 3-month prevalence of migraine was 2.6% (boys 1.6%, girls 3.5%) applying strict IHS criteria and 6.9% (boys 4.4%, girls 9.3%) with modified criteria; 12.6% (boys 8.3%, girls 16.7%) suffered from probable migraine, 0.07% fulfilled the criteria for chronic migraine, 4.5% (boys 4.6%, girls 4.3%) suffered from TTH, 0.2% from chronic TTH and 15.7% (boys 14.5%, girls 16.9%) from probable TTH. Headache and migraine were more common in girls than in boys and in teenagers, especially in girls, aiming at higher education. Recurrent headache and primary headache disorders are common complaints among German adolescents, especially among girls.

Assessment of Headache Among High School Students in Jordan

2017 ◽  
Vol 35 (2) ◽  
pp. 88-95 ◽  
Author(s):  
Mohammed ALBashtawy ◽  
Mohammad Al Qadire ◽  
Sami Aloush ◽  
Loai Tawalbeh ◽  
Manar AlAzzam ◽  
...  
Keyword(s):  
High School ◽  
High School Students ◽  
Health Care Providers ◽  
Primary Headache ◽  
Cross Sectional Study ◽  
Tension Type Headache ◽  
Care Providers ◽  
School Students ◽  
Cross Sectional ◽  
Type Headache

Headache is considered one of the most common complaints affecting all ages: children, adolescents, and adults. A school-based, cross-sectional study was conducted to assess primary headache among high school students aged 16–18 in Grades 11–12, over a period of 3 weeks (May 2017). A questionnaire was designed, in accordance with the International Headache Society’s criteria. The Pearson’s χ2 test was computed to show the differences between the variables. Nearly two thirds of the students reported having headache (19.0% tension-type headache, 8.8% migraine, and 39.0% unknown type). Nearly a quarter sought help for headache, and the most frequently used analgesic was acetaminophen (82.2%) followed by aspirin (5.1%). The current study revealed that the prevalence of headache and migraine was initially high and increased with age. Moreover, headache is one of the major public health problems among high school students. An education program conducted by school nurses and other health-care providers regarding headache and migraine is needed.

scholarly journals Diagnosis of primary headache in children younger than 6 years: A clinical challenge

Cephalalgia ◽  
2016 ◽  
Vol 37 (10) ◽  
pp. 947-954 ◽  
Author(s):  
Roberto Torriero ◽  
Alessandro Capuano ◽  
Rosanna Mariani ◽  
Roberto Frusciante ◽  
Samuela Tarantino ◽  
...  
Keyword(s):  
International Headache Society ◽  
Primary Headache ◽  
Tension Type Headache ◽  
Preschool Age ◽  
Clinical Feature ◽  
Primary Headaches ◽  
Clinical Challenge ◽  
Adults And Children ◽  
Type Headache

Background Criteria defined by the International headache Society are commonly used for the diagnosis of the different headache types in both adults and children. However, some authors have stressed some limits of these criteria when applied to preschool age. Objective Our study aimed to describe the characteristics of primary headaches in children younger than 6 years and investigate how often the International Classification of Headache Disorders (ICHD) criteria allow a definitive diagnosis. Methods This retrospective study analysed the clinical feature of 368 children younger than 6 years with primary headache. Results We found that in our patients the percentage of undefined diagnosis was high when either the ICHD-II or the ICHD-III criteria were used. More than 70% of our children showed a duration of their attacks shorter than 1 hour. The absence of photophobia/phonophobia and nausea/vomiting significantly correlate with tension-type headache (TTH) and probable TTH. The number of first-degree relatives with migraine was positively correlated to the diagnosis of migraine in the patients ( p < 0.001). Conclusions Our study showed that the ICHD-III criteria are difficult to use in children younger than 6 years. The problem is not solved by the reduction of the lowest duration limit for the diagnosis of migraine to 1 hour, as was done in the ICHD-II.

Prevalence of primary headache disorders diagnosed according to ICHD-3 beta in three different social groups

Cephalalgia ◽  
2015 ◽  
Vol 36 (6) ◽  
pp. 579-588 ◽  
Author(s):  
Elena R Lebedeva ◽  
Natalia R Kobzeva ◽  
Denis Gilev ◽  
Jes Olesen
Keyword(s):  
Blood Donors ◽  
Medication Overuse Headache ◽  
Social Groups ◽  
Primary Headache ◽  
Tension Type Headache ◽  
Headache Disorders ◽  
Primary Headache Disorders ◽  
Type Headache ◽  
One Year ◽  
Age Range

Background The aim of our study was to estimate the one-year prevalence of primary headache disorders in three different social groups using the third edition beta of the International Classification of Headache Disorders (ICHD-3 beta). Material and methods The study population included a total of 3124 participants: 1042 students (719 females, 323 males, mean age 20.6, age range 17–40), 1075 workers (146 females, 929 males, mean age 40.4, age range 21–67) and 1007 blood donors (484 females, 523 males, mean age 34.1, age range 18–64). We used a semi-structured, validated face-to-face interview. Results The age-adjusted one-year prevalence of migraine in females was significantly higher ( p < 0.001) in students (41.9%) than in workers (19.2%) and blood donors (18.7%). Age-adjusted prevalence of migraine among males did not differ among the three groups: 4.5% in students, 4.9% in workers and 4.5% in blood donors. Age-adjusted prevalence of tension-type headache (TTH) among females was almost the same in students and blood donors (68.8% and 66.7%) but female workers had a lower prevalence of TTH (57%). Age-adjusted prevalence of TTH among males did not differ significantly between students and blood donors (55.8% and 58.1%) but male workers had a significantly lower ( p < 0.001) prevalence of TTH (30.7%). The prevalence of chronic headache in students (TTH and/or migraine) was 3% and of probable medication-overuse headache 3%, significantly more than in workers and blood donors. Conclusion Headache prevalence was high and differed markedly among the three social groups. It is important that headache epidemiology also focus on socially defined groups in order to target future preventive efforts.

Cluster Headache and Other Trigeminal Autonomic Cephalalgias

2018 ◽  
Vol 38 (06) ◽  
pp. 603-607
Author(s):  
Brian McGeeney
Keyword(s):  
Cluster Headache ◽  
Health Care Providers ◽  
Treatment Options ◽  
Primary Headache ◽  
Trigeminal Autonomic Cephalalgias ◽  
Care Providers ◽  
Private Industry ◽  
Primary Headache Disorders ◽  
New Treatments ◽  
Delays In Diagnosis

AbstractThe trigeminal autonomic cephalalgias are a group of distinct primary headache disorders that share common characteristics of strict unilateral headache often accompanied by unilateral cranial autonomic features. Cluster headache is the most well-known example, but other than neurologists, practitioners often have limited familiarity with these disorders and treatment options. Delays in diagnosis are typical and treatment options remain suboptimal, associated with limited scientific research into these brain disorders. Improved familiarity with core clinical features by health care providers should lead to earlier referral to specialists, and this education is the responsibility of headache medicine specialists. Optimistically, the last few years have seen lobbying for more federal research support in headache medicine and there has been renewed interest by private industry in potential new treatments for trigeminal autonomic cephalalgias.

Sign in / Sign up

Export Citation Format

Share Document