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Robert Kaniecki, MD

JAMA. 2003;289:1430-1433.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

INTRODUCTION

The lifetime prevalence of headache is more than 90%.¹ In recent population-based surveys of US adults, nearly 25% annually report recurrent episodes of severe headache and 4% daily or near-daily headache.^2-4 Prescription or nonprescription products are used by 9% of US adults each week to treat headache, matching hypertension as the primary reason for medication use.⁵ The majority of patients presenting to physicians will have primary headache syndromes such as tension-type, cluster, and migraine. Less than 2% of patients in office and 4% of patients in emergency department settings will be found to have headaches secondary to significant pathology.⁶

Clinical Scope of Headache

Recurrent headaches provoke consultation when they are debilitating, frequent, or associated with worrisome neurological or systemic symptoms. Episodic tension-type headache annually affects 38% of US adults, yet rarely requires medical attention given the typical absence of disability or concerning symptoms.^7-8 Cluster headache generally leads to significant . . . [Full Text of this Article]

Diagnostic Steps in Headache

Management of Primary Headache

Conclusion

Author Affiliation: The Headache Center, Department of Neurology, University of Pittsburgh, Pittsburgh, Pa.

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