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Headache
is one of man’s most frequent complaints presenting frequently to the
ophthalmologist or the neurologist. While head pains are most frequently
caused by primary headache disorders such as migraine or muscle
contraction, the differential diagnosis is one of the longest in
medicine (Olesen, 1988). Some have listed as many as 300 different types
of headache. It is believed, by most of those commonly dealing with
headache, that the new classification system of the International
Headache Society (IHS) is helpful in approaching the diagnosis and
treatment of headache by providing standardized diagnostic criteria
(Table 1).
Headache
is presumed to affect more than 80% of the population (Harrison, 1970;
Beeson and McDermott, 1971; Philips, 1977a). This chapter concentrates
on headache types other than migraine. Migraine is discussed elsewhere (Troost
BT: Migraine and Other Headaches, 2000) It is not
the purpose of this chapter to discuss all headaches and their
etiologies in detail since many fine books (Appenzeller, 1976; Friedman
et al., 1978; Lance, 1978; Ryan and Ryan, 1978; Dalessio and Silberstein,
1993; Kudrow, 1980; Raskin, 1988); and review articles (Appenzeller et
al., 1979; Diamond et al., 1979; Caviness and O'Brien, 1980; Lance,
1981; Thompson, 1982; Moskowitz, 1984; Baumel, 1994; Dalessio, 1994;
Lipton and Stewart, 1993; Stewart, et al., 1992) are available (see also
the journals, Headache and Cephalalgia). Nevertheless, we hope to
present a rational approach to the patient with headaches who presents
to the ophthalmologist, neurologist, or neurosurgeon.
Table
1: IHS Classification of Headache
1.
Migraine
1.1
Migraine without aura
1.2
Migraine with aura
1.3
Ophthalmoplegic migraine
1.4
Retinal migraine
1.5
Childhood periodic syndromes that may be precursors to or
associated with migraine
1.6
Complications of migraine
1.7
Migrainous disorder not fulfilling above criteria
2.
Tension-type headache
2.1
Episodic tension-type headache
2.2
Chronic tension-type headache
2.3
Tension-type headache not fulfilling above criteria
3.
Cluster headache and chronic paroxysmal hemicrania
3.1
Cluster headache
3.2
Chronic paroxysmal hemicrania
3.3
Cluster headache-like disorder not fulfilling above criteria
4.
Miscellaneous headaches not associated with structural lesion
4.1
Idiopathic stabbing headache
4.2
External compression headache
4.3
Cold stimulus headache
4.4
Benign cough headache
4.5
Benign exertional headache
4.6
Headache associated with sexual activity
5.
Headache associated with head trauma
5.1
Acute posttraumatic headache
5.2
Chronic posttraumatic headache
6.
Headache associate with vascular disorders
6.1
Acute ischemic cerebrovascular disorder
6.2
Intracranial hematoma
6.3
Subarachnoid hemorrhage
6.4
Unruptured vascular malformation
6.5
Arteritis
6.6
Carotid or vertebral artery pain
6.7
Venous thrombosis
6.8
Arterial hypertension
6.9
Headache associated with other vascular disorder
7.
Headache associated with nonvascular intracranial disorder
7.1
High CSF pressure
7.2
Low CSF pressure
7.3
Intracranial infection
7.4
Intracranial sarcoidosis and other noninfectious inflammatory
diseases
7.5
Headache related to intrathecal injections
7.6
Intracranial neoplasm
7.7
Headache associated with other intracranial disorder |
8.
Headache associated with substances or their withdrawal
8.1
Headache induced by acute substance use or exposure
8.2
Headache induced by chronic substance use or exposure
8.3
Headache from substance withdrawal (acute use)
8.4
Headache from substance withdrawal (chronic use)
8.5
Headache associated with substances but with uncertain mechanism
9.
Headache associated with noncephalic infection
9.1
Viral infection
9.2
Bacterial infection
9.3
Headache related to other infection
10.
Headache associated with metabolic disorder
10.1
Hypoxia
10.2
Hypercapnia
10.3
Mixed hypoxia and hypercapnia
10.4
Hypoglycemia
10.5
Dialysis
10.6
Headache related to other metabolic abnormality
11.
Headache or facial pain associated with disorder of cranium, neck,
eyes, ears, nose sinuses, teeth, mouth, or other facial or cranial
structures
11.1
Cranial bone
11.2
Neck
11.3
Eyes
11.4
Ears
11.5
Nose and sinuses
11.6
Teeth, jaws, and related structures
11.7
Temporomandibular joint disease
12.
Cranial neuralgias, nerve trunk pain, and deafferentation pain
12.1
Persistent (in contrast to tic-like) pain of cranial nerve origin
12.2
Trigeminal neuralgia
12.3
Glossopharyngeal neuralgia
12.4
Nervous intermedius neuralgia
12.5
Superior laryngeal neuralgia
12.6
Occipital neuralgia
12.7
Central causes of head and facial pain other than tic douloureux
12.8
Facial pain not fulfilling criteria in groups 11 or 12
13.
Headache not classifiable |
Olesen
J. Headache Classification Committee of the International Headache
Society. Classification and diagnostic criteria for headache disorders,
cranial neuralgia, and facial pain. Olesen (1988)
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