Medicus, Vol. 28 No. 1 Neurologija, 2019.
Review article
Diagnostic and Therapeutic Approach to Headaches
Davor Jančuljak
Abstract
Headache is not just a symptom of an organic or psychological disorder, but also a distinct clinical entity. The standard diagnostic criteria for all headache disorders are established according to the International Classification of Headache Disorders and are based mainly on clinical features of headache disorders and their accompanying symptoms, while other diagnostic procedures are used to either exclude or demonstrate a pathomorphological substrate. Primary headaches (migraine, tension-type headache and trigeminal autonomic cephalalgias) are caused by a dysfunctional antinociceptive mechanism in the central nervous system that cannot be detected by a macromorphological substrate using conventional neuroimaging techniques, as opposed to secondary headaches. Treatment of headache varies, depending on the diagnosis. The treatment focuses on acute pain and its concomitant symptoms, as well as on the prevention of recurrent headache episodes. Either pharmacological or non-pharmacological management option may be used for the treatment of headache. The choice of analgesic drug is based on evidence of clinical efficacy and on guidelines for specific headache treatment. There are general analgesics that are used in all clinical forms of headache, as well as drugs specifically designed for certain types of headache disorders (triptans, corticosteroids, indomethacin). Pharmacoprophylaxis of headache with specific drugs is indicated in frequent episodic or chronic headaches in patients who poorly respond to acute therapy or have a reduced quality of life due to headaches. Non-pharmacological treatment includes various invasive and non-invasive methods of treatment focused on pain alleviation or headache prophylaxis.
Keywords
headache; acute; chronic headache; analgesics; non-pharmacological treatment of headache
Hrčak ID:
216814
URI
Publication date:
6.2.2019.
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