ICHD-2 CLINICAL FEATURES, EPIDEMIOLOGICAL DATA, ASSESSMENT AND TREATMENTS OF ADULT PATIENTS WITH HEADACHE

Headache, in all its varieties, is common and can seriously affect the quality of life. The International Classification of Headache Disorders (ICHD) is an indepth hierarchical classification of headaches published by the International Headache Society. It contains explicit (operational) diagnostic criteria for headache disorders. The current revision, ICHD-2, was published in 2004. The ICHD-2 classification puts cranial neuralgias and other types of neuralgia in a different category. According to this system, there are 19 types of neuralgias and headaches due to different central causes of facial pain. Moreover, the ICHD-2 includes a category that contains all the headaches that cannot be classified. Although the ICHD-2 is the most complete headache classification there is and it includes frequency in the diagnostic criteria of some types of headaches (primarily primary headaches), it does not specifically code frequency or severity which are left at the discretion of the examiner. Headache disorders are the most common complaints worldwide. Migraine, tension type and cluster headaches account for majority of primary headaches and improvise a substantial burden on the individual, family or society at large. In the Pain Therapy Unit of Verona University, Borgo Roma Hospital, was treated from 2006 to 2013 a total of 315 patients with headache. Epidemiological data have been reported. This study aimed to assess the prevalence and statistical characteristics, of headache. The study subjects were 315 of which 73 (23,2%) were males and 242 (76,8%) were females. The prevalence for migraine was 166 patients (52,7%), migraine without aura 138 patients; migraine with aura was 28 patients. The prevalence of tension type of headache was found to be in 57 patients (18,1%). The prevalence of migraine + tension type headache was 70 patients (22,2%). The prevalence of cluster headache was 7 patients (2,2%). The prevalence of secondary headaches was 15 patients (4,8%). CONCLUSION Prevalence and burden of primary headache disorders was substantial in this community. The population of patients suffering with headaches is vast. The most critical element in headache evaluation is the history. The targeted history not only differentiates primary from secondary headaches but also provides a realistic list of conditions associated with secondary headache. Several of these conditions do present with specific physical, psychological and pathological findings. The ability simply to recognize but a few straightforward clinical findings directs the evaluation in the proper direction. The most common types of headache are the "primary headache disorders", such as tension-type headache and migraine. They have typical features; migraine, for example, tends to be pulsating in character, affecting one side of the head, associated with nausea, disabling in severity, and usually lasts between 3 hours and 3 days. Rarer primary headache disorders are trigeminal neuralgia (a shooting face pain), cluster headache (severe pains that occur together in bouts), and hemicrania continua (a continuous headache on one side of the head) (4). Patients with headaches must learn about their headache disorder, and must be willing to take steps to treat it. This includes not just taking medication, but also monitoring the effectiveness of treatments and making lifestyle modifications to optimize headache control. The doctor will provide medication and education, but more than perhaps any other disorder, actual treatment is up to the patient.