An Update on the Less-known Group of Other Primary Headaches – A Review

Abstract

Headache represents one of the most common symptoms in the emergency department. A systematic approach to headache classification is essential for diagnosis and efficient therapeutic management. New International Headache Classification (ICHD-3 beta) criteria provide a dynamic clinically useful instrument, establishing both uniform terminology and consistent operational diagnostic criteria for a broad range of headache disorders. This article reviews and highlights developments in our knowledge of “Other Primary Headaches”, including primary stabbing headache, primary cough headache, primary exercise headache, primary headache associated with sexual activity, hypnic headache, primary thunderclap headache, cold-stimulus headache, nummular headache, external-pressure headache and new daily persistent headache. Clinicians should be aware that these headaches may be symptomatic to structural lesions and therefore require careful neuroimaging and laboratory evaluation.

From Buns to Braids and Ponytails: Entering a New Era of Female Military Hair-Grooming Standards

“…A less commonly discussed primary headache disorder includes external-pressure headaches, which result from either sustained compression or traction of the soft tissues of the scalp, usually from wearing headbands, helmets, or tight hairstyles. 16 Additional at-risk groups include those who chronically wear surgical scrub caps or flight caps, especially if clipped or pinned to the hair. In our 38 years of combined military clinical experience, we can attest that these types of headaches are common among female servicemembers.…”

“…The diagnostic criteria for an external-pressure headache, commonly referred to by patients as a "ponytail headache," includes at least 2 headache episodes triggered within 1 hour of sustained traction on the scalp, maximal at the site of traction and resolving within 1 hour after relieving the traction. 16 Management includes removal of the pressure-causing source, usually a tight ponytail or bun. FIGURE 2.…”