Vol. 21 No. 1 (2023)
An Approach To:

Approach to: Headache

PDF HTML
  • Benjamin Rehany,
  • Zachary Rehany
Benjamin Rehany
McGill University
Bio
Zachary Rehany
Bio
Man with hands over his ears.
DOI: https://doi.org/10.26443/mjm.v21i1.958

Published 2022-10-23

Keywords

  • Headaches,
  • Imaging,
  • Family Medicine

How to Cite

1.
Rehany B, Rehany Z. Approach to: Headache. McGill J Med [Internet]. 2022 Oct. 23 [cited 2025 Oct. 16];21(1). Available from: https://mjm.mcgill.ca/article/view/958

Copyright (c) 2022 Benjamin Rehany, Zachary Rehany

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

Crossref
Scopus
Google Scholar
Europe PMC

Abstract

Headaches are one of the most common reasons for visiting a family physician. The estimated lifetime prevalence of a headache is about 66%. (1) They pose a significant burden on the patient’s quality of life, and in fact contribute to about 20% of work absences. (2) Fortunately, most cases are benign. The following article presents an approach to headaches, differentiating between benign and worrisome causes and management.

PDF HTML

Downloads

Download data is not yet available.

References

  1. (1) Becker WJ, Findlay T, Moga C, Scott NA, Harstall C, Taenzer P. Guideline for primary care management of headache in adults. Can Fam Physician. 2015 Aug;61(8):670-9. PMID: 26273080; PMCID: PMC4541429. https://pubmed.ncbi.nlm.nih.gov/26273080/
  2. (2) Latinovic R, Gulliford M, Ridsdale L. Headache and migraine in primary care: consultation, prescription, and referral rates in a large population. J Neurol Neurosurg Psychiatry. 2006 Mar;77(3):385-7. doi: 10.1136/jnnp.2005.073221. PMID: 16484650; PMCID: PMC2077680.
  3. (3) Goadsby PJ, et al. Pathophysiology of Migraine: A Disorder of Sensory Processing. Physiol Rev. 2017 Apr;97(2):553-622. doi: 10.1152/physrev.00034.2015. PMID: 28179394; PMCID: PMC5539409
  4. (4) Strassman AM, Raymond SA, Burstein R. Sensitization of meningeal sensory neurons and the origin of headaches. Nature. 1996 Dec 12;384(6609):560-4. doi: 10.1038/384560a0. PMID: 8955268.
  5. (5) Ahmed F. (2012). Headache disorders: differentiating and managing the common subtypes. British journal of pain, 6(3), 124–132. https://doi.org/10.1177/2049463712459691
  6. (6) Ducros A, Bousser MG. Thunderclap headache. BMJ. 2013 Jan 8;346:e8557. doi: 10.1136/bmj.e8557. PMID: 23303883.
  7. (7) Douglas, et al. Expert Panel on Neurologic Imaging. ACR Appropriateness Criteria® Headache. [Online Publication]. Reston (VA) American College of Radiology (ACR); 2013. Available at: https://acsearch.acr.org/docs/69482/Narrative/
  8. (8) Richie MB, Josephson SA. A Practical Approach to Meningitis and Encephalitis. Semin Neurol. 2015 Dec;35(6):611-20. doi: 10.1055/s-0035-1564686. Epub 2015 Nov 23. PMID: 26595861.
  9. (9) Klein AM, Loder E. Postpartum headache. Int J Obstet Anesth. 2010 Oct;19(4):422-30. doi: 10.1016/j.ijoa.2010.07.009. Epub 2010 Sep 15. PMID: 20833030.
  10. (10) Chen, John J. MD, PhD; Bhatti, M. Tariq MD Papilledema, International Ophthalmology Clinics: Summer 2019 - Volume 59 - Issue 3 - p 3-22 doi: 10.1097/IIO.0000000000000274
  11. (11) Wakerley BR. Medication-overuse headache. Pract Neurol. 2019 Oct;19(5):399-403. doi: 10.1136/practneurol-2018-002048. Epub 2019 Jul 4. PMID: 31273078.
  12. (12) Rose JJ, Wang L, Xu Q, McTiernan CF, Shiva S, Tejero J, Gladwin MT. Carbon Monoxide Poisoning: Pathogenesis, Management, and Future Directions of Therapy. Am J Respir Crit Care Med. 2017 Mar 1;195(5):596-606. doi: 10.1164/rccm.201606-1275CI. Erratum in: Am J Respir Crit Care Med. 2017 Aug 1;196 (3):398-399. PMID: 27753502; PMCID: PMC5363978.
  13. (13) Lagman-Bartolome AM, Gladstone J. Metabolic headaches. Neurol Clin. 2014 May;32(2):451-69. doi: 10.1016/j.ncl.2013.11.011. Epub 2014 Jan 11. PMID: 24703539.
  14. (14) Miłowska K, Grabowska K, Gabryelak T. Zastosowanie promieniowania elektromagnetycznego w medycynie [Applications of electromagnetic radiation in medicine]. Postepy Hig Med Dosw (Online). 2014 May 8;68:473-82. Polish. doi: 10.5604/17322693.1101572. PMID: 24864099.
  15. (15) Choosing Wisely. American College of Radiology: Five things physicians and patients should question
  16. (16) Headache Classification Committee of the International Headache Society (IHS) The International Classification of Headache Disorders, 3rd edition. Cephalalgia. 2018 Jan;38(1):1-211. doi: 10.1177/0333102417738202. PMID: 29368949.
  17. (17) Burch R. Migraine and Tension-Type Headache: Diagnosis and Treatment. Med Clin North Am. 2019 Mar;103(2):215-233. doi: 10.1016/j.mcna.2018.10.003. Epub 2018 Dec 3. PMID: 30704678.
  18. (18) Modi S, Lowder DM. Medications for migraine prophylaxis. Am Fam Physician. 2006 Jan 1;73(1):72-8. Erratum in: Am Fam Physician. 2006 Nov 15;74(10):1685. PMID: 16417067. https://pubmed.ncbi.nlm.nih.gov/16417067/
  19. (19) Hainer BL, Matheson EM. Approach to acute headache in adults. Am Fam Physician. 2013 May 15;87(10):682-7. PMID: 23939446.
  20. (20) Aleksenko D, Maini K, Sánchez-Manso JC. Medication Overuse Induced Headache. [Updated 2021 Jul 2]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from:https://www.ncbi.nlm.nih.gov/books/NBK470171/
  21. (21) Bianchi, A et al. (2004). Role of magnesium, coenzyme Q10, riboflavin, and vitamin B12 in migraine prophylaxis. Vitamins and hormones, 69, 297–312. https://doi.org/10.1016/S0083-6729(04)69011-X
  22. (22) Beghi E, Bussone G, D’Amico D, Cortelli P, Cevoli S, Manzoni GC, Torelli P, Tonini MC, Allais G, De Simone R, D’Onofrio F. Headache, anxiety and depressive disorders: the HADAS study. The journal of headache and pain. 2010 Apr 1;11(2):141-50.