Headaches in older patients: special problems and concerns

Any patient older than 50 years who develops headaches for the first time or who has a change in a chronic headache pattern should be investigated for an underlying cause or exacerbating condition. Several headache syndromes occur almost exclusively in older people. One of these, temporal arteritis, needs to be recognized and promptly treated with corticosteroids to avoid permanent visual loss. Other causes of headache that are more common in older people include subdural hematomas, trigeminal neuralgia, herpes zoster infection, and malignancies.