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Development of chronic daily headache: a clinical study
E L Spierings1, M Schroevers, P C Honkoop
1Department of Neurology, Brigham & Women's Hospital and Harvard Medical School, Boston, Mass., USA.
Headache
|December 23, 2004
Summary
Most chronic daily headaches develop gradually from intermittent ones over years. However, some cases arise abruptly, often after head, neck, or back injuries, particularly from motor vehicle accidents.
Area of Science:
- Neurology
- Epidemiology
Background:
- Chronic daily headache (CDH) affects a significant portion of the population.
- Understanding the developmental pathways of CDH is crucial for effective management.
Purpose of the Study:
- To investigate the onset and progression patterns of chronic daily headaches in a patient cohort.
- To differentiate between abrupt and gradual transitions to daily headache patterns.
Main Methods:
- Retrospective analysis of 258 patients diagnosed with chronic daily headache.
- Classification of headache onset into "from onset" and "initially intermittent" categories.
- Analysis of transition types (abrupt vs. gradual) and associated circumstances.
Main Results:
- 78% of patients initially had intermittent headaches, with 19% transitioning abruptly and 81% gradually.
- Abrupt onset was frequently linked to head, neck, or back injuries (61%), often from motor vehicle accidents.
- Gradual transitions to daily headaches averaged 10.7 years.
Conclusions:
- Chronic daily headache development is heterogeneous, with both abrupt and gradual pathways observed.
- Traumatic injuries are a significant factor in the abrupt onset of chronic daily headaches.
- The long duration of gradual transitions highlights the need for early intervention in intermittent headache management.
