Review Article
Volume 12 Issue 8 - 2020
Headache - A Broad Overview
Roy G Beran1,2,3*, Geoffrey Quail4 and Frank JE Vajda4,5
1University of New South Wales, Australia
2Griffith University, Queensland, Australia
3Sechenov First State University, Moscow, Russia
4Monash University, Alfred Hospital, Victoria, Australia
5University of Melbourne, Royal Melbourne Hospital, Victoria, Australia
*Corresponding Author: Roy G Beran, University of New South Wales, Australia and Griffith University, Queensland, Australia and Sechenov First State University, Moscow, Russia.
Received: June 01, 2020; Published: July 08, 2020


Headache is one of the most common problems to present to the neurologist and accounts for approximately 5% of all general practice (GP) consultations. The approach to headache is similar to all other medicine, namely the need for an accurate history, comprehensive physical examination and investigation, if required. It is imperative to identify the ‘red flags’, which mandate referral for more in-depth evaluation.

From the GP perspective, it is important to examine lifestyle changes and to address these. One should ensure that the overuse of medications is both anticipated and optimally controlled. Immediate treatment may be as simple as over-the-counter analgesics. If more is required, having addressed lifestyle issues, overuse syndrome and ‘red flags’, it may be worth considering involving a neurologist.

Prophylactic treatment depends on the headache type, such as tricyclic antidepressants for tension-type headaches, selection of a choice of anti-migrainous agents for unequivocal migraines, and the use of propranolol for those headaches which fall somewhere between tension-type headaches and migraines, always being cognisant of the potential adverse effects that may attach to those medications.

Keywords: Headache; Overuse; Lifestyle; Medications; Prophylaxis


  1. Kenteu B., et al. “Neuroimaging of headaches in patients with normal neurological examination: protocol for a systematic review”. BMJ Open2 (2018): e020190.
  2. Frese T., et al. “Headache in general practice: frequency, management and result of encounter”. International Scholarly Research Notices (2014): 169428.
  3. Beran RG. “Neurology for General Practitioners”. Elsevier, Sydney (2012).
  4. Beran RG and Spira PJ. “Levetiracetam in chronic daily headache: A double-blind, randomised, placebo-controlled study (The Australian KEPPRA Headache Trial) [AUS-KHT]”. Cephalalgia5 (2011): 530-536.
  5. Nattero G., et al. “Psychological aspects of weekend headache suffers in comparison with migraine patients”. Headache2 (1989): 93.
  6. Sahota RK and Dexter MD. “Sleep and headache syndrome: A clinical review”. Headache 2 (1990): 80-84.
  7. Idiman F., et al. “Headache in sleep apnoea syndrome”. Headache6 (2004): 603-606.
  8. Costanigro M., et al. “The wine headache: Consumer perceptions of sulfites and willingness to pay for non-sulfited wines”. Food Quality and Preference 31 (2014): 81-89.
  9. Bic Z., et al. “In search of the ideal treatment for migraine headache”. Medical Hypotheses 1 (1998): 1-7.
  10. Evans CS., et al. “Analysis of commercially available cheeses for the migraine inducer tyramine by thin-layer chromatography and spectrophotometry”. Analyst 10 (1988): 1605-1606.
  11. Hauge AW., et al. “Characterisation of consistent triggers of migraines with aura”. Cephalalgia 4 (4): 416-438.
  12. Diamond S., et al. “Migraine headache – working for the best outcome”. Postgraduate Medical Journal 8 (2016): 174-183.
  13. Zaeem Z., et al. “Headaches: A review of the role of dietary factors”. Current Neurology and Neuroscience Reports 16 (2016).
  14. Baad-Hansen L., et al. “Effects of systemic monosodium glutamate (MSG) on headache and percranial muscle sensitivity”. Cephalalgia1 (2010): 68-76.
  15. Grant EC. “The pill, hormone replacement therapy, vascular and mood over-activity and mineral imbalance”. Journal of Nutritional and Environmental Medicine 2 (1998): 105-116.
  16. Da Silva AN and Lake AE. “Clinical aspects of medication overuse headaches”. Headache1 (2014): 211-217.
  17. Doods H., et al. “CGRP antagonists: unravelling the role of CGRP in migraine”. Trends in Pharmacological Sciences 11 (2007): 580-587.
  18. Troost T. “Botulinum toxin type A (Botox®) in the treatment of migraine and other headaches”. Expert Review of Neurotherapeutics1 (2004): 27-31.
  19. Holroyd KA., et al. “Management of chronic tension-type headache with tricyclic antidepressant medication, stress management therapy, and their combination: A randomized controlled trial”. The Journal of the American Medical Association 285 (2001): 2208-2215.
  20. Leone M., et al. “A review of the treatment of primary headaches. Part 1: Migraine”. The Italian Journal of Neurological Sciences 16 (1995): 577-586.
  21. Louis P and Spierings ELH. “Comparison of flunarizine (Sibelium®) and pizotifen (Sandomigran®) in migraine treatment: A double-blind study”. Cephalalgia4 (1982): 197-203.
  22. Saper JR. “Chronic headache syndrome”. Neurologic Clinics 2 (1989): 387-412.
  23. Hackett GI., et al. “Chronic muscle contraction headache: The importance of depression and anxiety”. Journal of the Royal Society of Medicine 80 (1987): 689-691.
  24. Buring JE., et al. “Low dose aspirin for migraine prophylaxis”. The Journal of the American Medical Association 13 (1990): 1711-1713.
  25. Graham JR., et al. “Fibrotic disorders associated with methysergide therapy for headache”. The New England Journal of Medicine 274 (1966): 359-368.
  26. Mathew NT and Ali S. “Valproate in the treatment of persistent chronic daily headache. An open label study”. Headache2 (1991): 71-74.
  27. Spira PJ and Beran RG. “Gabapentin in prophylaxis of chronic daily headache: A randomised, placebo-controlled study”. Neurology 2 (2003): 1753-1759.
  28. Rompel PW and Bauermeister H. “Aetiology of migraine and prevention with carbamazepine (Tegretol) results of a double-blind, cross-over study”. South African Medical Journal 4 (1970): 75-80.
  29. Silverstrini M., et al. “Topiramate in the treatment of chronic migraine”. Cephalalgia 23 (2003): 820-824.
Citation: Roy G Beran., et al. “Headache - A Broad Overview”. EC Neurology”. EC Neurology 12.8 (2020): 17-22.

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