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GUIDELINES FOR TREATMENT OF PRIMARY HEADACHES BY THE CROATIAN SOCIETY FOR NEUROVASCULAR DISORDERS OF THE CROATIAN MEDICAL ASSOCIATION AND CROATIAN SOCIETY FOR PAIN PREVENTION, REFERENCE CENTER FOR THE HEADACHE OF THE MINISTRY OF HEALTH OF THE REPUBLIC OF CROATIA, REFERENCE CENTER CROATIA FOR DIAGNOSIS AND TREATMENT OF ACUTE AND CHRONIC PAIN BY THE MINISTRY OF HEALTH OF REPUBLIC OF CROATIA AND HEADACHE SECTION OF CROATIAN NEUROLOGICAL SOCIETY OF THE CROATIAN MEDICAL ASSOCIATION
VANJA BAŠIĆ KES
; Department of Neurology, Reference Center of the Ministry of Health for Neuroimmunology and Neurogenetics, University Hospital Centre „Sestre milosrdnice“, Zagreb, Croatia
VIŠNJA SUPANC
; Department of Neurology, Reference Center of the Ministry of Health for Neuroimmunology and Neurogenetics, University Hospital Centre „Sestre milosrdnice“, Zagreb, Croatia
LUCIJA ZADRO MATOVINA
; Department of Neurology, Reference Center of the Ministry of Health for Neuroimmunology and Neurogenetics, University Hospital Centre „Sestre milosrdnice“, Zagreb, Croatia
NEVENA GRBIĆ
; Department of Neurology, Reference Center of the Ministry of Health for Neuroimmunology and Neurogenetics, University Hospital Centre „Sestre milosrdnice“, Zagreb, Croatia
IRIS ZAVOREO
; Department of Neurology, Reference Center of the Ministry of Health for Neuroimmunology and Neurogenetics, University Hospital Centre „Sestre milosrdnice“, Zagreb, Croatia
MARIJANA LISAK
; Department of Neurology, Reference Center of the Ministry of Health for Neuroimmunology and Neurogenetics, University Hospital Centre „Sestre milosrdnice“, Zagreb, Croatia
TOMISLAV BREITENFELD
; Department of Neurology, Reference Center of the Ministry of Health for Neuroimmunology and Neurogenetics, University Hospital Centre „Sestre milosrdnice“, Zagreb, Croatia
MARIJANA BOSNAR PURETIĆ
; Department of Neurology, Reference Center of the Ministry of Health for Neuroimmunology and Neurogenetics, University Hospital Centre „Sestre milosrdnice“, Zagreb, Croatia
ARIJANA LOVRENČIĆ HUZJAN
; Department of Neurology, Reference Center of the Ministry of Health for Neuroimmunology and Neurogenetics, University Hospital Centre „Sestre milosrdnice“, Zagreb, Croatia
DAVOR JANČULJAK
; Department of Neurology, University Hospital Centre Osijek, Osijek Croatia
DAMIR PETRAVIĆ
; Department of Neurology, University Hospital Centre Zagreb, Zagreb, Croatia
KORALJKA BAČIĆ BARONICA
; Department of Neurology, Clinical Hospital „Sveti Duh“, Zagreb, Croatia
DARIJA MAHOVIĆ LAKUŠIĆ
; Department of Neurology, University Hospital Centre Zagreb, Zagreb, Croatia
MARISTELA STOJIĆ
; Department of Neurology, Clinical Hospital Dubrava, Zagreb, Croatia
MARINA TITLIĆ
; Department of Neurology, University Hospital Centre Split, Split, Croatia
ZLATKO HUCIKA
; Department of Neurology, General Hospital Zabok, Zabok, Croatia
DRAGAN SOLDO
; Health Center Zagreb-Center, Zagreb, Croatia
VLADIMIRA VULETIĆ
; Department of Neurology, University Hospital Centre Rijeka, Rijeka, Croatia
ZLATKO TRKANJEC
; Department of Neurology, Reference Center of the Ministry of Health for Neuroimmunology and Neurogenetics, University Hospital Centre „Sestre milosrdnice“, Zagreb, Croatia
Abstract
Introduction: Headache is one of the most frequent neurological conditions, so a big need for medications for headache treatment and other methods is needed for acute pain relief and chronic prevention of headaches. Aim: Knowing that headache is one of the most frequent conditions we wanted to summarise its treatment. Methods: We explored MEDLINE searches about the treatment of primary headaches. We also explored the Croatian scientifi c base Hrčak. Results: We found articles on both scientifi c bases, but have chosen only the most systemised. Discussion: According to International Headache Classifi cation there are two main types of headaches: primary headaches (migraine and its subtypes, tensiontype headache and its subtypes, trigeminal autonomic cephalgias) and secondary headaches (attributed to infection, head or neck trauma, cranial or cervical vascular disorders, non-vascular intracranial disorders, substance withdrawal, psychiatric conditions, pain attributed to the disorders of cranium, neck, eyes, ears, nose, sinuses, teeth, mouth or other facial or cervical structure). When managing a diagnosis of primary headache, it is important to make a difference between the primary and secondary headache, manage the right diagnosis of primary headache and decide on the right treatment for the acute or preventive phase of headache. The most used medications in headache treatment are nonspecifi c analgetics which can treat headaches, but also other pain disorders. Specifi c headache medication includes medications which can
treat only specifi c types of headaches. Except for the above, there are other methods in headache treatment which include a change of lifestyle, avoiding provocative factors, acupuncture and treatment with botulinum toxin. Conclusion: For primary headache treatment it is important to establish the right diagnosis and act fast in the treatment of acute headache attacks. For some patients, it is important to start a prophylactic treatment but also try to prevent a medication overuse headache. When treating a headache of any kind it is also important to take a whole picture of a patient and his/hers comorbidities and think about possible side effects. Changing a lifestyle and some complementary methods can help us in treating chronic headaches. We supplemented the guidelines published in 2018 with new drugs that have since been registered for the treatment of acute attacks and prophylaxis of migraine attacks.
Keywords
primary headache; treatment; migraine; tension-type headache; cluster headache
Hrčak ID:
294733
URI
Publication date:
27.2.2023.
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