CHAPTER 9 Headache Syndromes I. Headache Syndromes A. The International Headache Classification (ICHD) of primary and secondary headaches 1. Primary headaches a. Migraine i. Migraine without aura ii. Migraine with aura iii. Childhood periodic syndromes that are commonly precursors to migraine iv. Retinal migraine v. Complications of migraine vi. Probable migraine b. Tension-type headache i. Infrequent episodic tension-type headache ii. Frequent episodic tension-type headache iii. Chronic tension-type headache iv. Probable tension-type headache c. Cluster headache and other trigeminal autonomic cephalgias i. Cluster headache ii. Paroxysmal headache iii. Short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing (SUNCT) iv. Probable trigeminal autonomic cephalgia d. Other primary headaches i. Primary stabbing headaches ii. Primary cough headaches iii. Primary exertional headaches iv. Primary headache associated with sexual activity v. Hypnic headache (with sleep) vi. Primary thunderclap headache vii. Hemicrania continua viii. New daily persistent headaches 2. Secondary headaches a. Headache attributed to head and/or neck trauma b. Headache attributed to cranial or cervical vascular disorder c. Headache attributed to nonvascular intracranial disorder d. Headache attributed to substance or its abuse e. Headache attributed to infection f. Headache attributed to disorders of homeostasis g. Headache of facial pain attributed to disorder of cranium, neck, eyes, ears, nose, sinuses, teeth, mouth, or other facial or cranial structures h. Headache attributed to psychiatric disorder Migraines are more likely to be frontal than unilateral in children. Benign paroxysmal vertigo is a frequent precursor of migraine in children. Ibuprofen is more efficacious than triptans in children. B. International Headache Classification, 2nd Edition (ICHD-II) diagnostic criteria for migraine without aura 1. At least five attacks fulfilling criteria 2 through 4 2. Headache attacks lasting 4 to 72 hours 3. Headache has at least two of the following characteristics: a. Unilateral location b. Pulsating quality c. Moderate or severe pain intensity d. Aggravation by or causing avoidance of routine physical activity 4. During headache, at least one of the following: a. Nausea and/or vomiting b. Photophobia and phonophobia 5. Not attributed to another disorder
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