Useful Headache Guidelines

headache-disordersDiagnosis and treatment of headache

Major Recommendations and Clinical Highlights

  • Headache is diagnosed by history and physical examination with limited need for imaging or laboratory tests.

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New Headache Classification System

michigan-brainThe International Classification of Headache Disorders, Third Edition (ICHD-III beta version) is now complete and ready for field testing.

“It’s out, it’s published, you should start using it immediately because it’s much better than the second edition,” Jes Olesen, MD, PhD, professor of neurology, University of Copenhagen, Glostrup Hospital, Denmark, told delegates to the 2013 International Headache Congress (IHC).

Dr. Olesen, who chaired the working group on migraine, encouraged delegates to start citing this new classification system and to participate in field testing, which will take place during the next few years, before publication of the final version.

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Migraine: A Brain Disorder

headache-disordersPositron emission tomography of patients experiencing the premonitory phase of migraine, prior to the headache setting in, shows activation in several areas of the brain, indicating that migraine is a brain disorder and not a response to pain stimuli.

The results are significant in terms of understanding the neurobiology of migraine and could have future implications for drug treatment, said study author Peter James Goadsby, MD, PhD, professor, neurology, and director, Headache Program, University of California at San Francisco, and president, International Headache Society.

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Chronic Daily Headache in U.S. Soldiers After Concussion

Objective.— To determine the prevalence and characteristics of, and factors associated with, chronic daily headache (CDH) in U.S. soldiers after a deployment-related concussion.

Methods.— A cross-sectional, questionnaire-based study was conducted with a cohort of 978 U.S. soldiers who screened positive for a deployment-related concussion upon returning from Iraq or Afghanistan. All soldiers underwent a clinical evaluation at the Madigan Traumatic Brain Injury Program that included a history, physical examination, 13-item self-administered headache questionnaire, and a battery of cognitive and psychological assessments. Soldiers with CDH, defined as headaches occurring on 15 or more days per month for the previous 3 months, were compared to soldiers with episodic headaches occurring less than 15 days per month. [Read more…]