European headache federation consensus on technical investigation for primary headache disorders
Year: 2015
Type: article
Abstract: The diagnosis of primary headache disorders is clinical and based on the diagnostic criteria of the International Headache Society (ICHD-3-beta). However several brain conditions may mimic primary headache disorders and laboratory investigation may be needed. This necessity occurs when the treating physician doubts for the primary origin of headache. Features that represent a warning for a possible underlying disorder causing the headache are new onset headache, change in previously stable headache pattern, headache that abruptly reaches the peak level, headache that changes with posture, headache awakening the patient, or precipitated by physical activity or Valsalva manoeuvre, first onset of headache ≥50 years of age, neurological symptoms or signs, trauma, fever, seizures, history of malignancy, history of HIV or active infections, and prior history of stroke or intracranial bleeding. All national headache societies and the European Headache Alliance invited to review and comment the consensus before the final draft. The consensus recommends brain MRI for the case of migraine with aura that persists on one side or in brainstem aura. Persistent aura without infarction and migrainous infarction require brain MRI, MRA and MRV. Brain MRI with detailed study of the pituitary area and cavernous sinus, is recommended for all TACs. For primary cough headache, exercise headache, headache associated with sexual activity, thunderclap headache and hypnic headache apart from brain MRI additional tests may be required. Because there is little and no good evidence the committee constructed a consensus based on the opinion of experts, and should be treated as imperfect.
Source: The Journal of Headache and Pain
Institutions: Athens Naval & Veterans Hospital, University of Copenhagen, Rigshospitalet, Essen University Hospital, University of Duisburg-Essen, King's College London, King's College Hospital, Leiden University Medical Center, Ghent University Hospital, Marqués de Valdecilla University Hospital, Instituto de Investigación Marqués de Valdecilla, Istanbul University-Cerrahpaşa, Istanbul University, Sechenov University, Sapienza University of Rome
Language: English
Subfield: Psychiatry and Mental health
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $3,990
Funders: King's College London, Universiteit Leiden, Universitair Ziekenhuis Gent, Universiteit Gent, Leids Universitair Medisch Centrum, Rigshospitalet, Faculty of Health and Medical Sciences, University of Western Australia, I.M. Sechenov First Moscow State Medical University, Instituto de Investigación Marqués de Valdecilla, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, Menzies Centre for Australian Studies, King's College London, University of London, Det Sundhedsvidenskabelige Fakultet, Københavns Universitet
OpenAlex ID: W2276551150