Nervous system


Pain/discomfort arising from pain-sensitive structures in the head.

Pain/discomfort arising from pain-sensitive structures in the head.


Worldwide, the condition has been ranked among the ten most disabling conditions by the World Health organization (WHO). In the global population, the prevalence of active headache disorder is 47%, migraine 10%, tension-type headache (TTH) 38% and chronic headache 3%; the disability attributable to TTH is larger worldwide than that due to migraine. Furthermore, headache is the most common neurological symptom presented by patients to general practitioners and neurologists

Epidemiological data on primary headache types
Epidemiological data on primary headache types | May A. (2018). Hints on Diagnosing and Treating Headache. Deutsches Arzteblatt international, 115(17), 299–308.
Age distribution of headache patients
Age distribution of headache patients | Wang, Y., Zhou, J., Fan, X., Li, X., Ran, L., Tan, G., Chen, L., Wang, K., & Liu, B. (2011). Classification and clinical features of headache patients: an outpatient clinic study from China. The journal of headache and pain, 12(5), 561–567.


Pain sensitive cranial structures:

Pain pathways in the head
The Calgary Guide |


Primary headaches:

Not caused by another disease with normal general physical and neurological examinations
  • Migraine
  • Tension headache
  • Trigeminal autonomic cephalalgias (of which cluster headache is the most prominent variety)
  • Group 4 ‘other primary headache disorders’: Consists of 10 rare headache syndromes with well-established primary nature
    • Benign exertional headaches
    • Primary stabbing headaches (“jabs and jolts syndrome”)
Primary headache disorders
Primary headache disorders. | Lee, V., Ang, L. L., Soon, D., Ong, J., & Loh, V. (2018). The adult patient with headache. Singapore medical journal, 59(8), 399–406. doi:10.11622/smedj.2018094

Secondary headaches:

Symptom of another disease; Any headache that does not fit into any of the four primary headache types is a secondary and therefore potentially dangerous headache.
  • Red flags for identifying a secondary headache: SSNOOP
    • Systemic symptoms (fever or weight loss)
    • Systemic disease (HIV infection, malignancy)
    • Neurologic symptoms or signs
    • Onset sudden (thunderclap headache)
    • Onset after age 40 years
    • Previous headache history (first, worst, or different headache)
Headache red flag signs
The Calgary Guide |

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