II. Epidemiology: Prevalence
- Episodic Headaches: 50% of U.S. adults suffer from Headaches at any period of time
- Progress to chronic Headaches in 3-4% of episodic Headache patients (Central Sensitization)
- Chronic Headaches: 2-4% of U.S. Adults
- Chronic daily symptoms in up to 30% of those with chronic Headaches
-
Headaches are a common trigger for medical care visits
- Acute Headache is the fourth most common reason for Emergency Department evaluation
- Half of Migraine Headache visits are to primary care
III. Pathophysiology: Headache Central Sensitization
- Frequent episodic Headaches may progress to chronic Headaches without management
- Results in Central Sensitization and Neuronal dysfunction
-
Central Sensitization Inappropriate response to low level stimuli
- Lower thresholds trigger pain response
- Exaggerated stimulus response
- Pain persists after trigger is removed
- Risk Factors for progression from episodic Headache to chronic Headache are specific to Headache type
IV. Causes: Primary Headaches
- See Acute Recurrent Headache
- See Chronic Nonprogressive Headache
- Common Primary Headaches
- Tension Headache (50% of acute Headaches)
- Common Migraine Headache (10% of acute Headaches)
- Other Primary Headaches
- Migraine with Aura (Classic Migraine)
- Cluster Headache and other trigeminal autonomic Cephalgias (<1%)
- Sexual Headache
V. Causes: Secondary Headaches
- See Headache Red Flag
-
Acute Localized Headache
- Sinus Headache (e.g. Acute Sinusitis)
- Myofacial pain
- Ophthalmologic Headache
- Acute Angle-Closure Glaucoma (severe Eye Pain)
- Generalized Headache
- Urgent or Life-treatening secondary causes with possible positive Head CT
- Urgent or Life-treatening secondary causes with negative Head CT
- Acute angle closure Glaucoma
- Bacterial Meningitis or Encephalitis
- Carbon Monoxide Poisoning
- Temporal Arteritis (Giant Cell Arteritis)
- Cerebral or dural venous sinus thrombosis
- Cavernous Sinus Thrombosis
- Cervical Artery Dissection (carotid dissection, Vertebrobasilar Dissection)
- Preeclampsia or Eclampsia (Pregnancy Induced Hypertension)
- Pituitary Apoplexy
- Hypertensive Emergency
- Reversible Cerebral Vasoconstriction Syndrome (RCVS)
- Miscellaneous secondary causes
VI. History
- See Headache History
VII. Exam
VIII. Differential Diagnosis
- See Headache Causes
- See Headache Red Flag
- See Organic Headache
IX. Diagnostics
X. Management
- See Nonpharmacologic Headache Treatment
- See Chronic Daily Headache
- Musculoskeletal Headaches
- Migraine Headache Management
- Iatrogenic Headaches and medication overuse
- Trigeminal Nerve Syndromes
- Organic Headaches
- Headache Management in women
-
Headaches in other specific cohorts
- See Headache in HIV
XI. References
- Ramdhan (2023) Crit Dec Emerg Med 37(5): 23-9
- Mayans (2018) Am Fam Physician 97(4): 243-51 [PubMed]
- Walling (2020) Am Fam Physician 101(7):419-28 [PubMed]
- Viera (2022) Am Fam Physician 106(3): 260-8 [PubMed]
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Related Studies
| Definition (MSHCZE) | Symptom bolesti v kraniální oblasti. Může se projevit izolovaně nebo jako součást nejrůznějších onemocnění souvisejících s hlavou. |
| Definition (MEDLINEPLUS) |
Almost everyone has had a headache. Headache is the most common form of pain. It's a major reason people miss days at work or school or visit the doctor. The most common type of headache is a tension headache. Tension headaches are due to tight muscles in your shoulders, neck, scalp and jaw. They are often related to stress, depression or anxiety. You are more likely to get tension headaches if you work too much, don't get enough sleep, miss meals, or use alcohol. Other common types of headaches include migraines, cluster headaches, and sinus headaches. Most people can feel much better by making lifestyle changes, learning ways to relax and taking pain relievers. Not all headaches require a doctor's attention. But sometimes headaches warn of a more serious disorder. Let your health care provider know if you have sudden, severe headaches. Get medical help right away if you have a headache after a blow to your head, or if you have a headache along with a stiff neck, fever, confusion, loss of consciousness, or pain in the eye or ear. NIH: National Institute of Neurological Disorders and Stroke |
| Definition (NCI_CTCAE) | A disorder characterized by a sensation of marked discomfort in various parts of the head, not confined to the area of distribution of any nerve. |
| Definition (NCI) | Pain in various parts of the head, not confined to the area of distribution of any nerve. |
| Definition (CSP) | pain in the cranial region that may occur as an isolated and benign symptom or as a manifestation of a wide variety of conditions. |
| Definition (MSH) | The symptom of PAIN in the cranial region. It may be an isolated benign occurrence or manifestation of a wide variety of HEADACHE DISORDERS. |
| Concepts | Sign or Symptom (T184) |
| MSH | D006261 |
| ICD9 | 784.0 |
| ICD10 | R51 |
| SnomedCT | 206946005, 271329006, 158296002, 139490008, 158298001, 162209005, 206948006, 25064002 |
| LNC | MTHU020860, LA15903-0, LA15854-5 |
| English | Headache, Headaches, CEPHALALGIA, CEPHALGIA, Cephalgia, HEAD PAIN, Cephalalgia, Cephalodynia, [D]Headache (context-dependent category), [D]Pain in head NOS (context-dependent category), [D]Headache, [D]Pain in head NOS, cephalalgia, cephalodynia, headache, Cephalalgias, Cephalgias, headache (symptom), headache, cephalalgia, Pain head, Headache NOS, Cephalodynias, Cranial Pain, Cranial Pains, Pain, Cranial, Pains, Cranial, Head Pain, Head Pains, Pain, Head, Pains, Head, Headache [Disease/Finding], cranial pain, headaches, pain in head, Pain;head, cephalgias, head pained, head ache, ache head, head pains, [D]Headache (situation), [D]Pain in head NOS (situation), HEADACHE, Have headaches, Head pain, Pain in head, HA - Headache, Headache (finding), cephalgia, head; pain, pain; head, Headache, NOS, Pain in head NOS, head pain |
| Portuguese | CEFALEIA, Dor na cabeça, Cefalalgia, Dor de cabeça, Cefaleia NE, CEFALALGIA, CEFALGIA, DOR DE CABECA, Cefaleia, Dor de Cabeça, Cefaleias, Cefalgia |
| Spanish | CEFALALGIA, Dolor de cabeza, Cefalea NEOM, [D]dolor en la cabeza, SAI (categoría dependiente del contexto), [D]cefalea (categoría dependiente del contexto), CABEZA, DOLOR, CEFALEA, CEFALGIA, [D]dolor en la cabeza, SAI, [D]cefalea, [D]dolor en la cabeza, SAI (situación), [D]cefalea (situación), Cefalalgia, cefalalgia, cefalea (hallazgo), cefalea, cefalgia, cefalodinia, dolor de cabeza, Cefaleas, Cefalea, Cefalgia |
| German | KOPFSCHMERZEN, Kopfschmerzen NNB, Schmerz Kopf, CEPHALGIE, KOPF SCHMERZHAFT, KOPFWEH, Kopfschmerzerkrankungen, Cephalgia, Zephalgie, Kopfschmerz, Cephalalgia |
| Italian | Cefalee, Dolore al capo, Cefalea NAS, Cefalodinia, Cefalgia, Cefalalgia, Dolore craniale, Mal di testa, Cefalea |
| Dutch | hoofdpijn NAO, cefalalgie, pijn hoofd, cefalgie, hoofd; pijn, pijn; hoofd, hoofdpijnen, hoofdpijn, Cefalalgie, Hoofdpijn, Pijn, hoofd- |
| French | Céphalée SAI, Céphalgie, Douleur dans la tête, CEPHALALGIE, CEPHALEES, GENE DANS LA TETE, MAL DE TETE, Céphalées, Céphalée, Mal de tête, Maux de tête, Céphalalgie, Céphalodynie, Douleur crânienne |
| Japanese | 頭痛ＮＯＳ, ｽﾞﾂｳ, ｽﾞﾂｳNOS, 頭痛, 片側頭痛 |
| Swedish | Huvudvärk |
| Finnish | Päänsärky |
| Russian | GOLOVNAIA BOL', ГОЛОВНАЯ БОЛЬ |
| Czech | Cefalalgie, Bolesti hlavy, Bolest hlavy, Bolest hlavy NOS, Cefalgie, cefalodynie, cefalalgie, cefalgie, bolest hlavy, cefalea, bolesti hlavy, hlava - bolesti |
| Korean | 두통 |
| Croatian | GLAVOBOLJA |
| Polish | Ból głowy |
| Hungarian | Fejfájás, Fejfájdalom, Fejfájás k.m.n., Cephalalgia, Cephalgia, Főfájás, Fejfájások |
| Norwegian | Hodepine, Cephalalgi, Cephalalgia |
