scholarly journals Headaches: new classification, clinical and diagnostic criteria in General Medicine

2014 ◽  
Vol 8 (3) ◽  
pp. 67-74
Author(s):  
Linda Iurato
Keyword(s):  
International Headache Society ◽  
General Medicine ◽  
Primary Headache ◽  
Secondary Headache ◽  
Headache Disorders ◽  
First Line ◽  
Primary Headache Disorders ◽  
Headache Diagnosis ◽  
Beta Version

The classification system of headaches is one of the oldest in medicine, and includes a hugeamount of types and causes. The International Headache Society has listed two broad categoriesfor headache disorders: primary headache disorders, which lack a clear underlying causativepathology, and secondary headache disorders, that have a known cause. This is an overviewaddressed to general practitioners to help making a first-line headache diagnosis basing on themost common types of headache listed in the 2013 International Classification of Headachedisorder 3rd edition (beta version). Although headache diagnosis and treatment have madesubstantial gains in the last decade, the disease is still underdiagnosed and undertreated:improvements in several areas are required, especially in General Medicine.

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.

scholarly journals Headache in Patients With Pituitary Lesions: A Longitudinal Cohort Study

Neurosurgery ◽  
2015 ◽  
Vol 78 (3) ◽  
pp. 316-323 ◽  
Author(s):  
Paul Rizzoli ◽  
Sherry Iuliano ◽  
Emma Weizenbaum ◽  
Edward Laws
Keyword(s):  
Primary Headache ◽  
Headache Disorder ◽  
Pituitary Surgery ◽  
Secondary Headache ◽  
Exact Nature ◽  
Questionnaire Response ◽  
Headache Diagnosis ◽  
Transsphenoidal Pituitary Surgery ◽  
The Relationship

Abstract BACKGROUND: Headache is a presenting feature in 37% to 70% of patients with pituitary tumor. Other pituitary lesions may also present with headache, and together these lesions account for about 20% of all primary brain lesions. Although pituitary lesions have been associated with headache, the exact nature of the relationship remains undefined. It is not always clear whether the presenting headache is an unrelated primary headache, a lesion-induced aggravation of a preexisting primary headache, or a separate secondary headache related to the lesion. OBJECTIVE: To characterize headache in patients referred to a multidisciplinary neuroendocrine clinic with suspected pituitary lesions and to assess changes in headache in those who underwent surgery. METHODS: We used a self-administered survey of headache characteristics completed by patients upon presentation and after any pituitary surgical procedure. RESULTS: One hundred thirty-three participants completed the preoperative questionnaire (response rate of 99%). The overall prevalence of headache was 63%. Compared to patients without headache, the group with headache was more likely to be female (P = .001), younger (P = .001), and to have had a prior headache diagnosis (P < .001). Seventy-two percent of patients reported headache localized to the anterior region of the head. Fifty-one patients with headache underwent transsphenoidal pituitary surgery. Headache was not associated with increased odds of having surgery (odds ratio, 0.90). At 3 months, 81% of surgically treated patients with headache who completed the postoperative questionnaire (21/26) reported improvement or resolution of headaches. No patient who completed the postoperative questionnaire (44/84) reported new or worsened headache. CONCLUSION: Frequent, disabling headaches are common in patients with pituitary lesions referred for neuroendocrine consultation, especially in younger females with a preexisting headache disorder. Surgery in this group was associated with headache improvement or resolution in the majority and was not found to cause or worsen headaches. Suggestions for revision of the International Classification of Headache Disorders diagnostic criteria pertaining to pituitary disorders are supported by these findings.

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.

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.

About differential diagnosis of cephalalgia (literature review)

10.12737/7239 ◽  
2014 ◽  
Vol 8 (1) ◽  
pp. 0-0
Author(s):  
Сапожников ◽  
Vladimir Sapozhnikov ◽  
Ларикова ◽  
A. Larikova
Keyword(s):  
Differential Diagnosis ◽  
Literature Review ◽  
Tension Headache ◽  
Primary Headache ◽  
Headache Disorders ◽  
Diagnostic Problem ◽  
Trigger Factors ◽  
Primary Headache Disorders ◽  
Adolescent Period

Cephalalgia must be the leading or sometimes the single symptom of 50 different diseases. This paper is devoted to analysis the causes, the clinical features and methods of cephalalgia diagnosis in children, teenagers, as well as the modifiable and trigger factors. There is cephalalgia in 40-60% children and the prevalence of the disease increases with age, especially with the beginning of school, and reaches a peak with adolescent period 75%, this explains the importance of this work. In the last 30 years, scientists have registered the growth of the epidemiology incidence of primary headache disorders, including the chronic form of headaches: tension headache has grown in ten times, migraines – in 5-6 times. Due to the uncertainty of subjective sensations in infancy the revelation of cephalalgia becomes sometimes quite a complicated diagnostic problem. Many researchers mention the difficulty of differentiation of various cephalalgia types in infancy due to insufficient sensibility of diagnostic criteria, which were offered by the International Classification of Headache Disorders 2003. 20-35% of cases cann’t classified. In this article, the importance of headache studying is accentuated, that is necessary for life optimization of children suffering from headaches.

Gibt es einen psychogenen Kopfschmerz?

2018 ◽  
Vol 37 (01/02) ◽  
pp. 38-42
Author(s):  
K. Henkel
Keyword(s):  
International Headache Society ◽  
International Classification ◽  
Psychische Erkrankungen ◽  
Headache Disorders ◽  
Psychische Erkrankung ◽  
Eine Hohe ◽  
Sekundäre Kopfschmerzen ◽  
Psychiatrische Störung ◽  
Beta Version

ZusammenfassungEs besteht eine hohe Komorbidität zwischen primären Kopfschmerzen und psychischen Erkrankungen. Eine gegenseitige Verstärkung und gemeinsame ätiologische Faktoren werden vermutet und wurden zum Teil nachgewiesen, so zum Beispiel bei Migräne und Depressionen. Eine nosologische Einteilung als sekundärer “Kopfschmerz zurückzuführen auf eine psychiatrische Störung“ verlangt eine hinreichende Evidenz für eine Auslösung oder wesentliche Verstärkung des Kopfschmerzes durch die psychische Erkrankung. Dieser Nachweis kann nur in Einzelfällen erfolgen. Größere systematische Untersuchungen fehlen. Die International Classification of Headache Disorders der International Headache Society erkennt auch in ihrer dritten Auflage (Beta-Version) nur die Somatisierungsstörung und die psychotische Störung als mögliche psychische Erkrankungen für die Auslösung sekundärer Kopfschmerzen an. Im Anhang der Klassifikation finden sich weitere psychische Erkrankungen, die möglicherweise sekundäre Kopfschmerzen auslösen können. Weitere prospektive und Längsschnittstudien sind nötig, um diese Zusammenhänge künftig besser beurteilen zu können.

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.

scholarly journals Symptom-based clinical profiles in the classification of post-traumatic headache

Neurology ◽  
2018 ◽  
Vol 91 (23 Supplement 1) ◽  
pp. S28.2-S28
Author(s):  
Andrew H Ahn ◽  
Sylvia M Lucas
Keyword(s):  
Unmet Need ◽  
Clinical Manifestations ◽  
Primary Headache ◽  
Current Data ◽  
Headache Disorders ◽  
Primary Headache Disorders ◽  
Specific Outcome ◽  
Post Traumatic ◽  
Definition Of

There are currently no established therapies for post-traumatic headache (PTH). One key obstacle standing in the way of meeting this unmet need is the fundamental gap in our understanding of the clinical course and functional impact of PTH. In this presentation we examine the existing schema used to characterize the clinical characteristics of PTH, including the International Classification of Headache Disorders (ICHD), and find that they leave major unresolved questions about the diagnosis, classification, and measurement of the clinical impact of PTH. Specifically, current data suggest that the ICHD classification, which is based on the extent of brain injury and the duration of condition, have limited prognostic and treatment implications. There are several challenges to the classification of PTH, as the clinical manifestations of PTH do not map well to the primary headache disorders, and the definition of the continuous and chronic daily headache require further study. Importantly, the existing classification do not provide or imply specific outcome measures for PTH, again a fundamental roadblock to testing therapeutic hypotheses for PTH. We hypothesize that a symptom-based classification is needed to begin an examination of these unresolved questions, and to establish clinically relevant endpoints for research and clinical trials for effective therapies.

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.

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