HEADACHE

KATHERINE ARIAS
KAROLINA BORJA
MICHELLE RIVAS

DEFINITION

A pain located in the

head, as over the eyes,
at the temples, or at
the base of the skull.
12-16 % prevalence
Tension most
common

CAUSES OF HEADACHES
Traction or dilatation of intracranial or extracranial
arteries.
Traction of large extracranial veins
Compression, traction or inflammation of cranial and
spinal nerves
Spasm and trauma to cranial and cervical muscles.
Meningeal irritation and raised intracranial pressure

CLASSIFICATION

MIGRAINE: IHS CRITERIA

5 attacks of

Headache lasting 4-72 hours.

Must be associated with nausea
or vomiting or photophobia and
phonophobia
Must have 2 of the following
1.
2.
3.
4.

Unilateral
Pulsating
Moderately severe.
Aggravated by physical activity

MIGRAINE WITHOUT AURA

At least 5 attacks with criteria B-D
B. Headache attacks lasting 4-72 h (untreated or
unsuccessfully treated)
C. Headache has 2 of the following characteristics:
1. unilateral location
2.pulsating quality
3.moderate or severe pain intensity
4.aggravation by or causing avoidance of routine physical activity
(eg, walking, climbing stairs)

D. During headache 1 of the following:

1. nausea and/or vomiting
2.photophobia and phonophobia

MIGRAINE WITH AURA

Migraine with
typical aura

Migraine with
brainstem
aura

Retinal
migraine

Hemiplegic
migraine

MIGRAINE WITH TYPICAL AURA

At least 2 attacks fulfilling criteria B and C
B. 1 of the following fully reversible aura symptoms:
1. visual
2. sensory
3. speech and/or language
4. motor
5. brainstem
6. retinal
C. 2 of the following 4 characteristics:
1. 1 aura symptom spreads gradually over 5 min
2. each individual aura symptom lasts 5-60 min
3. 1 aura symptom is unilateral
4. aura accompanied or followed in <60 min by headache

MIGRAINE WITH BRAINSTEM AURA

A. At least 2 attacks fulfilling criteria B and C
below,
B. Aura with reversible visual, sensory and/or
speech/language symptoms, but not motor or retinal
C. 2 of the following brainstem symptoms:
1. dysarthria
2. Vertigo
3. Tinnitus
4. hypacusis
5. Diplopia
6.decreased level of consciousness

PHASES O MIGRAINE
PREMONITION: hunger, energy surges,
irritability.
PRODROME: aura. (Vomiting, photophobia,
phonophobia)
Throbbing pain headache phase
POSTDROME. Fatigue.

CONSIDER PREVENTION WHEN:

Interferes with patients daily routine.
>2/week
Presence of uncommon migraine conditions
Hemiplegic migraine
Migraine with prolonged aura.

Tension
Headache

Tension headaches are caused by muscle

contractions in the head and neck regions.
The pain is typically bilateral, oppressive,
dull, deep, in band mild or moderate
and not aggravated by daily physical
activities.

A tension headache is the most

common type of headache. It can
cause mild, moderate, or intense pain
in your head, neck, and behind your
eyes.

Symptoms
dull head pain

pressure around the forehead

tenderness around the forehead and scalp.

Since tension headaches are often caused

by specific triggers, identifying the factors
that cause your headaches is one way to
prevent future episodes.

No associated nausea
and anorexia may exist,
and sometimes
photophobia or
phonophobia

Most have increased

sensitivity of pericranial
musculature.

With various
episodic (headaches
present for less than
15 days/month)
They usually last
longer than migraine
at lacks . 30 minutes
to 7 days

Chronic (headache
for more than 15
days/month)

Trigeminal autonomic cephalalgia

Cluster headache
Paroxysmal hemicrania (chronic or episodic)
Short-lasting unilateral neuralgiform headache
attacks with conjunctival injection and tearing
(SUNCT)

Cluster headache
Is a neurological disorder characterized by recurrent,
severe headaches on one side of the head, typically
around the eye. There are often
accompanying autonomic symptoms during the
headache:

Eye watering
Nasal congestion
Swelling around the eye
Pupil constriction
Redness of
the conjunctiva
Facial blushing,
Swelling, or sweating

Duration: ranges from about 15 to 180 minutes.

Paroxysmal hemicrania
Multiple short, severe headaches a day, often
more than five, with most lasting between 5 and
30 minutes each.

Short-lasting unilateral neuralgiform headache

attacks with conjunctival injection and tearing
(SUNCT)
Is a rare type of trigeminal autonomic
cephalalgia
Each attack can last from five seconds to six
minutes and may occur up to 200 times daily.
Tear flow
Ipsilateral ptosis
Eyelid edema
Nasal blockage
Conjunctival
injection

Bibliography
1.Winkler,A.,Stelzhammer,B.,Kerschbaumsteiner,K
.,Meindl,M.,Dent,W.,Kaaya,J.,&...Schmutzhard,E.
(2009).Theprevalenceofheadachewithemphasisont
ension-typeheadacheinruralTanzania:acommunitybasedstudy.Cephalalgia(WileyBlackwell),29(12),1317-1325.doi:10.1111/j.14682982.2009.01885.x
2.Doniger,S.B.(2006).Headaches.RDH,26(1),6265.RetrievedfromEBSCOhost