Primary Headache Disorders
A framework for diagnosing migraine, tension-type headache and cluster headache clinically after screening for secondary-headache red flags and medication overuse.
Definition
Primary headache disorders are recurrent headaches caused by dysfunction of pain-sensitive head and neck networks rather than another underlying lesion. The common clinical phenotypes are migraine, tension-type headache and cluster headache.
First principles
Primary and secondary headache are different diagnostic jobs
Primary headache is the disorder itself, most commonly migraine, tension-type headache or cluster headache. Secondary headache is caused by another disorder such as subarachnoid haemorrhage, infection, giant cell arteritis, glaucoma, raised intracranial pressure or medication overuse. The first task is always to screen for the latter.
This page is exam revision material, not medical advice, and must not be used for patient care. Always check drug doses against the BNF and current guidance. Full disclaimer.