chronic daily headache
Last reviewed 04/2021
- 5% of North American and Western European populations have headache on at least 15 days a month for, on average, four or more hours a day
- a chronic daily headache is not just tension-type headache, nor is it all just due to medication overuse
- if a doctor gets a history of frequent headache they need to pursue its basis
- clinician needs to be aware of features suggestive of sinister
or secondary headache. These include (1):
- pain of sudden onset
- fever
- marked change in pain character or timing
- neck stiffness
- pain associated with higher centre complaints
- pain associated with neurological disturbance e.g. clumsiness or weakness
- pain associated with local tenderness, such as of the temporal artery
- if a positive diagnosis that the headache is benign cannot be made then patients with a headache that is of recent onset or with neurological signs require brain imaging with computed tomography or magnetic resonance imaging (1)
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