Book contents
- Emergency Headache
- Emergency Headache
- Copyright page
- Contents
- Contributors
- Preface
- 1 Introduction
- 2 Epidemiology of Headache in the Emergency Department
- 3 Approach to History Taking and the Physical Examination
- 4 Approach to Investigations
- 5 Thunderclap Headache in the Emergency Department
- 6 Other Secondary Headaches in the Emergency Department
- 7 The Migraine Patient in the Emergency Department
- 8 The Patient with a Trigeminal Autonomic Cephalalgia in the Emergency Department
- 9 Other Primary Headache Disorders That Can Present to the Emergency Department
- 10 Medication Overuse Headache in the Emergency Department
- 11 Approach to the Pediatric Patient with Headache in the Emergency Department
- 12 Approach to Pregnant or Lactating Patients with Headache in the Emergency Department
- 13 Approach to the Elderly Patient with Headache in the Emergency Department
- 14 Preventing Emergency Department Visits in Primary Headache Patients and Prevention of Bounce-Backs to the Emergency Department
- Index
- References
9 - Other Primary Headache Disorders That Can Present to the Emergency Department
Published online by Cambridge University Press: 09 October 2017
Book contents
- Emergency Headache
- Emergency Headache
- Copyright page
- Contents
- Contributors
- Preface
- 1 Introduction
- 2 Epidemiology of Headache in the Emergency Department
- 3 Approach to History Taking and the Physical Examination
- 4 Approach to Investigations
- 5 Thunderclap Headache in the Emergency Department
- 6 Other Secondary Headaches in the Emergency Department
- 7 The Migraine Patient in the Emergency Department
- 8 The Patient with a Trigeminal Autonomic Cephalalgia in the Emergency Department
- 9 Other Primary Headache Disorders That Can Present to the Emergency Department
- 10 Medication Overuse Headache in the Emergency Department
- 11 Approach to the Pediatric Patient with Headache in the Emergency Department
- 12 Approach to Pregnant or Lactating Patients with Headache in the Emergency Department
- 13 Approach to the Elderly Patient with Headache in the Emergency Department
- 14 Preventing Emergency Department Visits in Primary Headache Patients and Prevention of Bounce-Backs to the Emergency Department
- Index
- References
Summary
AbstractSummary of epidemiology and headache features in other primary headache disorders
Although other primary headache disorders such as cough headache, exercise headache, headache associated with sexual activity, thunderclap headache, hypnic headache, and new daily persistent headache are less common than migraine and tension-type headache, these disorders can be severe, disabling, and misdiagnosed. A good proportion of them coexist with other primary headache disorders. In addition, they may be associated with underlying structural pathology, and it is paramount that they are investigated for secondary causes. Diagnosis of the other primary headache disorders requires exclusion of secondary mimics, as stipulated in the International Classification of Headache Disorders, third edition beta version [1]. Treatment and prognosis are dependent on the diagnosis, and the majority are indomethacin responsive.
This chapter reviews the epidemiology, clinical features, pathophysiology, and management of these less common headache disorders that may present to the emergency department (ED).
Table 9.1| Primary cough headache | Primary exercise headache | Primary headache associated with sexual activity | Primary thunderclap headache | Hypnic headache | New daily persistent headache | |
|---|---|---|---|---|---|---|
| Prevalence | 1% | 12% | 1% | 43/100,000 per year | 0.07–0.3% | 0.1% |
| Age of onset | 60s | 20s | 20s–40s | Not available | 60s | 20s–30s |
| Gender | M > F | M > F | M > F | Not available | F > M | F > M |
| Headache features | ||||||
| Onset | Sudden | Sudden | Gradual or explosive | Explosive | Abrupt, wakes patient from sleep | Starts within 24 hours |
| Character | Sharp, stabbing | Dull, diffuse, pulsatile | Dull and with increasing intensity with sexual activity orSevere in intensity, throbbing | Severe intensity | Dull, throbbing | Tension or migraine phenotype |
| Typical location | VertexFrontalOccipitalTemporal | Bilateral | FrontalOccipitalDiffuse | DiffuseOccipital | Diffuse, bilateralFrontotemporal | Unilateral or generalized |
| Duration | Seconds to minutes | Hours | Minutes to hours | Hours to few days | Minutes to few hours | Daily and continuous for ≥3 months |
| Triggers | CoughingSneezingStrainingLaughing | Sustained physical exertionShort burst of physical exertion | Sexual activityMasturbation | SpontaneousValsalva maneuversSexExertionStress | Sleep (120–480 min into sleep) | Antecedent viral illnessCranial surgeryMenarcheStressful life events |
- Type
- Chapter
- Information
- Emergency HeadacheDiagnosis and Management, pp. 88 - 98Publisher: Cambridge University PressPrint publication year: 2017
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