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Headache
Introduction to Clinical Neurology
Daniel Lowenstein, MD
Andy Josephson, MD
Wade Smith, MD, PhD
Dan Lowenstein, MD
Potential Conflicts of Interest
- None
Robert B. and Ellinor Aird Professor of Neurology
Director, UCSF Epilepsy Center
Department of Neurology, UCSF School of Medicine
Learning Objectives
Learning Objectives
o Describe the major clinical features of migraine, tension
headache, cluster headache, and trigeminal neuralgia.
o Explain the principles of acute and prophylactic therapy for
primary headache disorders.
o Describe the clinical features of the worrisome headache.
o Describe the presentation and acute therapeutic
considerations for patients with giant cell (temporal) arteritis,
tumor-associated headache with intracranial hypertension,
and subarachnoid hemorrhage.
Introduction
The t reatment of headache in 1200 BC
Cartoon drawn by P. Cunningham, from Lance, Mechanism and Management of Headache, Butterworths, 1982
o Global prevalence among adults of current headache disorder
(symptomatic at least once within the last year) is 47%.
o Half to three quarters of the adults aged 1865 years in the world have had headache in the last year and among those individuals,
more than 10% have reported migraine.
o Headache on 15 or more days every month affects 1.74% of the worlds adult population.
o Despite regional variations, headache disorders are a worldwide
problem, affecting people of all ages, races, income levels and
geographical areas.
From the Wor ld Heal th Organizat ion (2012)
The most important question of al l !
Old
Migraine Tension-type Cluster Trigeminal neuralgia
Tumor-associated Giant cell (temporal) arteritis Subarachnoid hemorrhage
Primary Headache Disorders
Secondary Headache Disorders