ABSTRACT
Headache is one of the most common complaints among patients presenting to an outpatient
neurology practice. The evaluation, diagnosis, and treatment of headache can be rather
cumbersome and at times quite challenging for even the most seasoned neurologist.
Many complex issues that although not causative, can play an exacerbating role in
the genesis of headaches. In this article, the authors review some of the essential
elements that are part of headache evaluation including headache-specific history,
physical examination, warning signs of secondary headache disorders, and when to consider
further studies. They then provide a brief review on the diagnosis of primary headache
disorders according to the International Headache Society's International Classification of Headache Disorders,
2nd Edition (ICHD-2), and treatment strategies of the more common primary headache disorders
with a focus on migraine, trigeminal autonomic cephalalgias, tension-type headache,
and chronic daily headache.
KEYWORDS
Primary headache - migraine - trigeminal autonomic cephalgias - cluster headache -
tension-type headache
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Paul G. MathewM.D.
John R. Graham Headache Center
1153 Centre Street, Suite 4970, Jamaica Plain, MA 02130
eMail: PMATHEW@partners.org
