Headache all day
Searched over 200M research papers
Summary
9 papers analyzed
These studies suggest that chronic daily headaches have various causes and can be managed with medications, preventive treatments, and lifestyle changes, but require proper diagnosis and identification of triggers to improve outcomes.
Not a yes or no question
To use the Consensus Meter, try asking a simple yes or no question
Research summarized with Copilot
Beta20 papers analyzed
Understanding Chronic Daily Headache: Causes, Diagnosis, and Management
Introduction to Chronic Daily Headache (CDH)
Chronic daily headache (CDH) is a term used to describe headaches that occur on 15 or more days per month for at least three consecutive months, with each headache lasting four or more hours per day . This condition significantly impacts the quality of life and is often associated with underlying primary headache disorders such as migraines and tension-type headaches .
Etiology and Pathophysiology of Chronic Daily Headache
Primary and Secondary Causes
CDH can be classified into primary and secondary headaches. Primary headaches include chronic migraine, chronic tension-type headache, hemicrania continua, and new daily persistent headache (NDPH) . Secondary headaches are those caused by other medical conditions, such as stroke, tumor, or meningitis, and must be ruled out before diagnosing CDH.
Pathophysiology
The pathophysiology of CDH is not fully understood but is thought to involve central sensitization and neurogenic inflammation. Chronic migraines, a common subtype of CDH, often develop through a process of transformation characterized by increasing headache frequency over months or years. Risk factors for chronic migraines include female sex, high frequency of headaches before transformation, and obesity.
Clinical Presentation and Diagnosis
Symptoms and Diagnostic Criteria
Patients with CDH often present with severe intermittent headaches and a chronic baseline headache. Symptoms may include sleep disturbances, dizziness, anxiety, mood changes, and significant interference with daily activities. The International Classification of Headache Disorders (ICHD) provides criteria for diagnosing different types of headaches, including migraines and tension-type headaches.
Diagnostic Approach
The diagnostic approach to CDH involves a thorough patient history and physical examination to exclude secondary causes. Neuroimaging, such as MRI or CT scans, is generally not required unless there are atypical headache features or neurological abnormalities. Electroencephalography (EEG) is also not routinely used unless there are symptoms suggestive of a seizure disorder.
Treatment and Management
Preventive and Abortive Therapies
Effective management of CDH aims to reduce the frequency and severity of headaches through preventive treatments and complementary therapies. Preventive treatments may include medications such as beta-blockers, antidepressants, and anticonvulsants. It is also crucial to limit the use of abortive therapies to avoid medication-overuse headaches (MOH).
Behavioral and Lifestyle Modifications
Behavioral therapies, including cognitive-behavioral therapy (CBT) and biofeedback, have shown effectiveness in managing CDH. Patients are encouraged to identify and avoid potential dietary triggers, such as caffeine, nitrates, and certain cheeses, which may contribute to headaches. Regular sleep patterns, stress management, and physical activity are also important components of a comprehensive treatment plan.
Conclusion
Chronic daily headache is a complex and multifaceted condition that requires a thorough diagnostic approach to exclude secondary causes and identify the underlying primary headache disorder. Effective management involves a combination of preventive medications, behavioral therapies, and lifestyle modifications to reduce headache frequency and improve the quality of life for patients. Ongoing research is essential to better understand the pathophysiology of CDH and develop more effective treatment strategies.
Sources and full results
Most relevant research papers on this topic
