Headache see specific sections in Chapter 8 for International Headache Society criteria

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a. Migraine i. Migraine without aura: Idiopathic, recurrent headache manifested by attacks lasting 4-72 hours. Typical characteristics are unilateral location, pulsating quality, moderate-to-severe intensity, aggravation by routine physical activity, and associated with nausea, vomiting, photo- and phonophobia. At least five attacks fulfilling the aforementioned criteria.

ii. Migraine with aura: Idiopathic, recurrent disorder manifested by attacks of neurological symptoms localizable to cerebral cortex or brain stem, usually gradually developing over 5-20 minutes and lasting less than 60 minutes. Headache, nausea, and/or photophobia usually follow neurologic aura symptoms directly or after an interval of less than 1 hour. Headache usually lasts 4-72 hours, but may be completely absent.

b. Tension headache (episodic tension-type headache).

Recurrent episodes of headaches lasting minutes to days. Pain typically pressing/tightening in quality, of mild-to-moderate intensity, bilateral in location, and does not worsen with routine physical activity. Nausea is rare, but photophobia and phonophobia may be present. At least 10 previous headaches fulfilling these criteria c. Cluster headache.

Attacks of severe, strictly unilateral pain, orbital, supraorbital, and/or temporal, usually lasting 15-180 minutes and occurring from at least once every other day up to eight times per day. Associated with one or more of the following: conjunctival injection, lacrimation, nasal congestion, rhinorrhea, forehead and facial sweating, miosis, ptosis, eyelid edema. Attacks occur in series for weeks or months ("cluster" periods), separated by remissions of usually months or years.

d. Headache from intracranial hypertension (also called pseudotumor cerebri, benign intracranial hypertension; see "Idiopathic Intracranial Hypertension" section of Chapter 8).

All of the following:

i. Increased intracranial pressure (200 mm H2O) measured by lumbar puncture.

ii. Normal neurological findings, except for papilledema and possible nerve VI palsy.

iii. No mass lesion and no ventricular enlargement on neuroimaging.

iv. Normal or low protein and normal white cell count in CSF.

v. No evidence of venous sinus thrombosis.

e. Intractable headache, nonspecific.

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The Prevention and Treatment of Headaches

The Prevention and Treatment of Headaches

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