Chronic daily headache: nosology and pathophysiology

Area of Science:

• Neurology
• Clinical Medicine

Background:

• Systematic classification of primary headaches is inexact, relying on clinical features due to the absence of diagnostic markers.
• The International Headache Society classification provides homogenous clinical groups but struggles with frequent headache classification, especially chronic daily headache.
• Clinical research on chronic daily headache is limited and imprecise due to definition uncertainties.

Purpose of the Study:

• To address the challenges in classifying frequent headaches, particularly chronic daily headache.
• To propose a diagnostic approach for chronic daily headache that initiates clinical evaluation and sub-classification.

Main Methods:

• Review of current literature and classification systems for primary headaches.
• Analysis of the clinical significance and diagnostic difficulties associated with chronic daily headache.

Main Results:

• The scientific basis of chronic daily headaches remains undetermined.
• There is a consensus that chronic daily headache is a significant clinical problem for specialists.
• The proposed approach is to diagnose chronic daily headache as frequent headache, prompting further investigation.

Conclusions:

• Chronic daily headache classification requires a clearer definition and more rigorous research.
• A pragmatic approach to diagnosing chronic daily headache is proposed to facilitate clinical management.
• Further research is needed to establish the underlying pathophysiology and diagnostic markers for chronic daily headaches.