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headache
HEADACHE
Treatment Guideline Chart
Headache is a very common problem presenting to primary care physicians and neurologists.
Most headaches are diagnosed based on the history & physical exam w/ no imaging or laboratory examination necessary.
Other types of headaches such as secondary headaches may require further evaluation & referral to a specialist.

Headache References

  1. Evers S, Afra J, Frese A, et al. EFNS guideline on the drug treatment of migraine - revised report of an EFNS task force. Eur J Neurol. 2009 Sep;16(9):968-981. doi: 10.1111/j.1468-1331.2009.02748.x. PMID: 19708964
  2. Beithon J, Gallenberg M, Johnson K, et al. Diagnosis and treatment of headache. Institute for Clinical Systems Improvement (ICSI). https://www.icsi.org. Jan 2013. Accessed 16 Apr 2015.
  3. Headache Classification Committee of the International Headache Society (IHS). The International Classification of Headache Disorders, 3rd edition (beta version). Cephalalgia. 2013 Jul;33(9):629-808. http://www.ihs-classification.org. Accessed 24 Apr 2015. PMID: 23771276
  4. Institute of Health Economics Alberta Canada. Guideline for primary care management of headache in adults. Top Alberta Doctors . http://www.topalbertadoctors.org. Jul 2012. Accessed 18 Apr 2015.
  5. MacGregor E, Steiner T, Davies P. Guidelines for all healthcare professionals in the diagnosis and management of migraine, tension-type headache, cluster headache, medication-overuse headache, 3rd edition. British Association for the Study of Headache. http://www.bash.org.uk. 2010. Accessed 16 Apr 2015.
  6. National Institute for Health and Care Excellence (NICE). Headaches: diagnosis and management of headaches in young people and adults. NICE clinical guideline 150. National Institute for Health and Care Excellence. https://www.nice.org.uk. Sep 2012. Accessed 24 Apr 2015.
  7. Weaver-Agostoni J. Cluster headache. Am Fam Physician. 2013 Jul;88(2):122-128. http://www.aafp.org. Accessed 29 Apr 2015. PMID: 23939643
  8. Bajwa ZH, Smith JH. Acute treatment of migraine in adults. UpToDate. https://www.uptodate.com. Mar 2019. Accessed 04 Jun 2019.
  9. Headache Classification Committee of the International Headache Society (IHS). The international classification of headache disorders, 3rd edition (beta version). Cephalalgia. 2013 Jul;33(9):629-808. doi: 10.1177/0333102413485658. Accessed 2 May 2017. PMID: 23771276
  10. World Health Organization. Headache disorders. WHO. https://www.who.int. Apr 2016. Accessed 24 Mar 2017.
  11. Headache Classification Committee of the International Headache Society (IHS). The international classification of headache disorders, 3rd edition. Cephalalgia. 2018;38(1):1-211. doi: 10.1177/0333102417738202. Accessed 20 Feb 2018. PMID: 29368949
  12. Becker WJ, Findlay T, Moga C, et al. Guideline for primary care management of headache in adults. Can Fam Physician. 2015 Aug;61(8):670-679. Accessed 20 Feb 2019. PMID: 26273080
  13. Institute of Health Economics Alberta Canada. Primary care management of headache in adults clinical practice guideline. http://www.topalbertadoctors.org. Sep 2016. Accessed 20 Feb 2019.
  14. Pringsheim T, Davenport WJ, Mackie G, et al on behalf of the Canadian Headache Society Prophylactic Guidelines Development Group. Canadian Headache Society guideline for migraine prophylaxis. Can J Neurol Sci. 2012 Mar;39(2)(Suppl 2):1-59. PMID: 22683887
  15. Scottish Intercollegiate Guidelines Network (SIGN). Diagnosis and management of headache in adults: a national clinical guideline. SIGN. http://www.sign.ac.uk. Nov 2008.
  16. American Headache Society. The American Headache Society position statement on integrating new migraine treatments into clinical practice. Headache. 2019 Jan;59(1):1-18. doi: 10.1111/head.13456. PMID: 30536394
  17. Bajwa ZH, Smith JH. Preventive treatment of migraine in adults. UpToDate. https://www.uptodate.com. Dec 2018. Accessed 28 Feb 2019.
  18. Gelfand AA, Goadsby PJ. The role of melatonin in the treatment of primary headache disorders. Headache. 2016 Sep;56(8):1257-1266. doi: 10.1111/head.12862. PMID: 27316772
  19. Gilmore B, Michael M. Treatment of acute migraine headache. Am Fam Physician. 2011 Feb;83(3):271-280. PMID: 21302868
  20. Hainer B, Matheson E. Approach to acute headaches in adults. Am Fam Physician. 2013 May;87(10):682-687. http://www.aafp.org. Accessed 23 Apr 2015. PMID: 23939446
  21. Lipton RB, Diener H, Robbins MS, et al. Caffeine in the management of patients with headache. J Headache Pain. 2017;18(1):107. doi: 10.1186/s10194-017-0806-2. Accessed 3 Sep 2019. PMID: 29067618
  22. May A. Cluster headache: treatment and prognosis. UpToDate. https://www.uptodate.com. Mar 2019.
  23. May A, Leone M, Afra J, et al. EFNS guidelines on the treatment of cluster headache and other trigeminal-autonomic cephalalgias. Eur J Neurol. 2006 Oct;13(10):1066-1077. doi: 10.1111/j.1468-1331.2006.01566.x. PMID: 16987158
  24. Scottish Intercollegiate Guidelines Network (SIGN). Pharmacological management of migraine. SIGN. http://www.sign.ac.uk. Feb 2018.
  25. Smith JH. Acute treatment of migraine in adults. UpToDate. https://www.uptodate.com. 01 Aug 2019. Accessed 6 Sep 2019.
  26. Smith JH. Preventive treatment of migraine in adults. UpToDate. https://www.uptodate.com. 28 Aug 2019. Accessed 6 Sep 2019.
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