An Update on the Less-known Group of Other Primary Headaches – A Review

2014 ◽  
Vol 9 (1) ◽  
pp. 71
Author(s):  
Evangelia Kararizou ◽  
Anastasia Bougea ◽  
Dimitra Giotopoulou ◽  
Evangelos Anagnostou ◽  
Annika Gkiata ◽  
...  
Keyword(s):  
Primary Headache ◽  
External Pressure ◽  
Laboratory Evaluation ◽  
Primary Headaches ◽  
Primary Stabbing Headache ◽  
Headache Classification ◽  
International Headache Classification ◽  
Exercise Headache ◽  
Pressure Headache ◽  
Persistent Headache

Headache represents one of the most common symptoms in the emergency department. A systematic approach to headache classification is essential for diagnosis and efficient therapeutic management. New International Headache Classification (ICHD-3 beta) criteria provide a dynamic clinically useful instrument, establishing both uniform terminology and consistent operational diagnostic criteria for a broad range of headache disorders. This article reviews and highlights developments in our knowledge of “Other Primary Headaches”, including primary stabbing headache, primary cough headache, primary exercise headache, primary headache associated with sexual activity, hypnic headache, primary thunderclap headache, cold-stimulus headache, nummular headache, external-pressure headache and new daily persistent headache. Clinicians should be aware that these headaches may be symptomatic to structural lesions and therefore require careful neuroimaging and laboratory evaluation.

Chronic Post-Traumatic Headache – A Clinical Analysis in Relation to the International Headache Classification 2nd Edition

Cephalalgia ◽  
2005 ◽  
Vol 25 (2) ◽  
pp. 132-138 ◽  
Author(s):  
L Baandrup ◽  
R Jensen
Keyword(s):  
Multidisciplinary Treatment ◽  
Clinical Analysis ◽  
Tension Type Headache ◽  
Major Influence ◽  
Primary Headaches ◽  
Headache Classification ◽  
Post Traumatic ◽  
International Headache Classification ◽  
Headache Clinic ◽  
Type Headache

The clinical presentation of chronic post-traumatic headache in 53 patients from a highly specialized headache clinic was analysed and classified according to the diagnostic criteria of the primary headaches in The International Headache Classification 2nd Edition, and compared with the 1st Edition. All patients fulfilled the criteria for both editions indicating that the restrictions in the 2nd Edition have no major influence on the prevalence in specialized clinics. We found the phenomenology to be very heterogeneous, but the vast majority (77%) of patients presented with headache resembling chronic tension-type headache, either as the only manifestation or in combination with migraine symptoms. For the first time episodic tension-type headache is described as occurring after head trauma. The prevalence of coexisting analgesic overuse was 42% and the treatment outcome for these patients was just as favourable as in primary headaches, whereas the time-consuming multidisciplinary treatment demonstrated only very modest results.

Automatic diagnosis of primary headaches by machine learning methods

Open Medicine ◽  
2013 ◽  
Vol 8 (2) ◽  
pp. 157-165 ◽  
Author(s):  
Bartosz Krawczyk ◽  
Dragan Simić ◽  
Svetlana Simić ◽  
Michał Woźniak
Keyword(s):  
Machine Learning ◽  
Negative Impact ◽  
Life Quality ◽  
Primary Headache ◽  
Machine Learning Techniques ◽  
Future Research ◽  
Common Disease ◽  
Primary Headaches ◽  
Starting Point ◽  
Headache Diagnosis

AbstractPrimary headaches are common disease of the modern society and it has high negative impact on the productivity and the life quality of the affected person. Unfortunately, the precise diagnosis of the headache type is hard and usually imprecise, thus methods of headache diagnosis are still the focus of intense research. The paper introduces the problem of the primary headache diagnosis and presents its current taxonomy. The considered problem is simplified into the three class classification task which is solved using advanced machine learning techniques. Experiments, carried out on the large dataset collected by authors, confirmed that computer decision support systems can achieve high recognition accuracy and therefore be a useful tool in an everyday physician practice. This is the starting point for the future research on automation of the primary headache diagnosis.

Psychopathology in children and adolescents with primary headaches: Categorical and dimensional approaches

Cephalalgia ◽  
2013 ◽  
Vol 33 (16) ◽  
pp. 1311-1318 ◽  
Author(s):  
Francesco Margari ◽  
Elisabetta Lucarelli ◽  
Francesco Craig ◽  
Maria G Petruzzelli ◽  
Paola A Lecce ◽  
...  
Keyword(s):  
Behavioral Problems ◽  
Child Psychopathology ◽  
Psychiatric Comorbidity ◽  
Primary Headache ◽  
Tension Type Headache ◽  
Emotional And Behavioral Problems ◽  
Control Group ◽  
Primary Headaches ◽  
Healthy Children ◽  
Type Headache

Background Recurrent headache is common in childhood, but there is not a great amount of data on the associations between headaches and psychopathology in children. Objective The aim of this study is to examine the relationships between primary headaches and psychopathology in children, using both the categorical and dimensional assessment. Methods The sample consisted of 70 patients with primary headache compared to a matched sample of 50 healthy children. Psychiatric comorbidity was defined according to the diagnostic criteria of the Diagnostic and Statistical Manual of Disorders. Child psychopathology outcomes were assessed using child- and parent-reported standardized instruments. Results Internalizing and externalizing problems were significantly represented among children with headaches compared to the control group, respectively 63% and 27%, without significant differences between migraine and tension-type headache children. Moreover, a total of 26% of the children with a headache reported psychiatric comorbidity such as anxiety and mood disorders. Conclusion The dimensional approach improves accuracy in the recognition of emotional and behavioral problems compared to the categorical approach; however, the use of both of these approaches could be useful for clinical practice, treatment and research.

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

scholarly journals Diagnostic and classification tools for chronic headache disorders: A systematic review

Cephalalgia ◽  
2018 ◽  
Vol 39 (6) ◽  
pp. 761-784 ◽  
Author(s):  
Rachel Potter ◽  
Katrin Probyn ◽  
Celia Bernstein ◽  
Tamar Pincus ◽  
Martin Underwood ◽  
...  
Keyword(s):  
Primary Care ◽  
Chronic Headache ◽  
Tension Type Headache ◽  
Primary Headaches ◽  
Headache Disorders ◽  
Headache Classification ◽  
Headache Type ◽  
Expert Clinician ◽  
Primary Care Clinicians ◽  
Type Headache

Background or aim Despite guidelines and the International Classification of Headache Disorders (ICHD-III beta) criteria, the diagnosis of common chronic headache disorders can be challenging for non-expert clinicians. The aim of the review was to identify headache classification tools that could be used by a non-expert clinician to classify common chronic disorders in primary care. Methods We conducted a systematic literature review of studies validating diagnostic and classification headache tools published between Jan 1988 and June 2016 from key databases: MEDLINE, ASSIA, Embase, Web of Knowledge and PsycINFO. Quality assessment was assessed using items of the Quality of Diagnostic Accuracy Studies (QUADAS-2). Results The search identified 38 papers reporting the validation of 30 tools designed to diagnose, classify or screen for headache disorders; nine for multiple headache types, and 21 for one headache type only. We did not identify a tool validated in a primary care that can be used by a non-expert clinician to classify common chronic headache disorders and screen for primary headaches other than migraine and tension-type headache in primary care. Conclusions Despite the availability of many headache classification tools we propose the need for a tool that could support primary care clinicians in diagnosing and managing chronic headache disorders within primary care, and allow more targeted referral to headache specialists.

scholarly journals The headache and adverse events due to the use of personal protective equipment to combat Covid-19

2020 ◽  
pp. 55-56
Author(s):  
Erlene Roberta Ribeiro dos Santos
Keyword(s):  
Personal Protective Equipment ◽  
Work Disability ◽  
Healthcare Professionals ◽  
Soft Tissues ◽  
Extended Period ◽  
External Pressure ◽  
Protective Equipment ◽  
Primary Headaches ◽  
Continued Use ◽  
Object Of Study

Personal protective equipment such as a mask, face shield, and glasses for healthcare professionals has never been more widespread during is the occurrence of the Covid-19 pandemic. These devices compress the scalp tissue circumferentially and often leave pressure marks after its removal, as is often observed in the case of the mask. This situation has affected the work environment of professionals who have been at the forefront of combating Covid-19 since December 2019, in units dedicated to the care of infected patients. Therefore, we wonder about the need and importance of exploring the adverse event of prolonged use of personal protective equipment such as mask, face shield, and goggles associated with the triggering of external pressure headaches. The etiology of this type of headache is triggered by external pressure resulting from the sustained compression of the soft tissues of the epicrania, associated with the use of the equipment on the head, which can lead to work disability. For those who already suffer from primary headaches such as migraines, the damage can be greater, as the continued use of the accessory by pressing on sensitive areas for an extended period can increase the chance of triggering a crisis. Based on these notes, it is recommended that greater attention be paid to the care with the improvement of protective equipment as an object of study, in the search for alternatives that can minimize the damage caused.

scholarly journals Management of Primary Headache in the Emergency Department

2020 ◽  
Author(s):  
Richard Pescatore
Keyword(s):  
Emergency Department ◽  
Symptom Relief ◽  
Disease Process ◽  
Primary Headache ◽  
Overwhelming Majority ◽  
Diagnostic Process ◽  
Primary Headaches ◽  
Emergency Setting ◽  
Headache Management ◽  
Headache Patients

Headache is a common presentation to emergency departments (EDs), comprising nearly 4% of all ED admissions.‎1 While the overwhelming majority of patients present with a primary headache disorder, particularly migraine, the emergency physician’s role calls for the simultaneous exclusion of severe or life-threatening pathology while providing judicious and effective symptom relief.‎2 Notably, recent investigations suggest that this dual mandate performs well, excluding more than 99% of conditions resulting in serious adverse neurologic sequelae, though at the cost of high-frequency and low-yield advanced imaging utilization.‎3‎, 4 While a comprehensive understanding of the diagnostic process and underlying pathophysiology associated with headache disorders is critical for the emergency clinician, this review is meant to chiefly describe the treatment of primary headache and the variety, efficacy, and indications of those interventions. While individual headache type classification can be helpful in targeting approach or therapy, diagnosis can be difficult in the emergency setting, and primary headaches of most types are often approached similarly in the ED. Interestingly, the overwhelming majority of patients who present to an emergency department with acute primary headache have migraine, but the majority of patients receive a less specific diagnosis and a treatment that is correspondingly nonspecific.‎5 Importantly, however, the dynamic, diverse, and unique nature of different headache presentations to the ED make an algorithmic or step-wise approach to headache management ill-advised. The emergency practitioner must have a working knowledge of the array of treatment options available and apply therapies in a considered and informed manner. Following effective analgesia, however, the most important intervention emergency physicians can deliver for their headache patients is to connect them with outpatient physicians savvy about headache management, who will then provide these headache patients with appropriate acute therapeutics, initiate preventive therapy and provide anticipatory guidance about their disease process.‎6

The need for preventive therapy in primary headaches

2011 ◽  
pp. 46-49
Author(s):  
Mario Fernando Prieto Peres ◽  
Daniel Krempel Amado ◽  
André Leite Gonçalves ◽  
Reinaldo Ribeiro ◽  
Jorge Roberto Pagura ◽  
...  
Keyword(s):  
Preventive Treatment ◽  
Primary Headache ◽  
Preventive Therapy ◽  
Tension Type Headache ◽  
Primary Headaches ◽  
Correct Treatment ◽  
Treatment Type ◽  
Geographical Regions ◽  
Probable Migraine ◽  
Type Headache

Introduction: Primary headaches are common conditions. In Brazil, the prevalence of migraine is 15.2%, tension-type headache 13% and chronic daily headache (CDH) 6.9%. Although frequent disorders a proportion of patients are undertreated. Patients patterns of headache care can trend toward acute medication only and those in need of prevention may not receive it. Objective: To estimate the rates of preventive treatment in primary headache sufferers. Methods: A telephone interview containing questions about headache and socio-demographic characteristics was applied to 3,848 people from 27 States of Brazil, in its five geographical regions. We considered MIDAS > 10 points as a marker for the need of preventive treatment. Patients were asked if they were taking any medication on a daily basis or any treatment to prevent headaches from happening. Subjects were divided into: 1. Those who responded positively for the question regarding preventive treatment regardless of the treatment type. 2. Those who responded positively for the question, but only medications or treatments studied for migraine prevention, labeled as "Correct treatment" 3. Those who responded positively for the question, but only medications or treatments from the prevention consensus (Brazilian Headache Society), labeled as "Consensus treatment" Results: In total, 12.8% of primary headache sufferers had MIDAS higher than 10, meeting criteria for prophylactic treatment, but only 8.4% of them reported it, 3.9% were using a right preventive treatment. The percentage of patients in need for prevention was 24.7% in migraine, 15.6 % in probable migraine, 5 % for tension-type headache (TTH) and 4% for probable TTH. Only 2.6% of migraineurs, 7.5% of probable migraine patients, 4.3% of tension-type headache and 0% of probable TTH received proper preventive treatment Conclusion: Primary headaches are common, debilitating conditions but a substantial proportion of those who might need prevention do not receive it. Patient education, public health initiatives in order to deliver migraine and other primary headaches treatment for the general population should be considered not only in Brazil, but worldwide.

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.

scholarly journals Non-invasive methods for measuring vascular changes in neurovascular headaches

2017 ◽  
Vol 39 (4) ◽  
pp. 633-649 ◽  
Author(s):  
Henrik W Schytz ◽  
Faisal M Amin ◽  
Juliette Selb ◽  
David A Boas
Keyword(s):  
Migraine Without Aura ◽  
Near Infrared ◽  
Cerebral Blood Flow Velocity ◽  
Single Photon ◽  
Photon Emission ◽  
Primary Headache ◽  
Cerebral Vessels ◽  
Emission Tomography ◽  
Primary Headaches ◽  
Vascular Changes

Vascular changes during spontaneous headache attacks have been studied over the last 30 years. The interest in cerebral vessels in headache research was initially due to the hypothesis of cerebral vessels as the pain source. Here, we review the knowledge gained by measuring the cerebral vasculature during spontaneous primary headache attacks with the use of single photon emission tomography (SPECT), positron emission tomography (PET), magnetic resonance imaging (MRA) and transcranial Doppler (TCD). Furthermore, the use of near-infrared spectroscopy in headache research is reviewed. Existing TCD studies of migraine and other headache disorders do not provide solid evidence for cerebral blood flow velocity changes during spontaneous attacks of migraine headache. SPECT studies have clearly shown cortical vascular changes following migraine aura and the differences between migraine with aura compared to migraine without aura. PET studies have shown focal activation in brain structures related to headache, but whether the changes are specific to different primary headaches have yet to be demonstrated. MR angiography has shown precise changes in large cerebral vessels during spontaneous migraine without aura attacks. Future development in more precise imaging methods may further elucidate the pathophysiological mechanisms in primary headaches.

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