[Primary cephaleas. A revision of their diagnosis and therapeutic approach]

This review focuses on primary headaches, its diagnosis and treatment. For the IHS specialists they are: migraine, tension-type headache (TTH), cluster and others. Migraine: the second in prevalence and the first in morbility, clinical features and differences between migraine with (Ma) and without aura (Mo).

10% prevalence and 3:1 women to men proportion. Patophysiology: primary central nociception disorder with secondary vascular involvement.

specific and non-specific, acute and preventive. Psychiatric disorders and migraine: there is evidence of clinical and pharmacological links, mainly between Ma and several psychiatric disorders. Migraine in childrens: important clinical and therapeutic differences from adult, importance of family approach. Migraine and hormones: the importance of estrogen drop, as trigger factor, treatment. Migraine and epilepsy: both shares neuronal hyperexcitability pattern. Migraine and stroke: vascular and ischemic factors involved. Evidence-based medicine: improves treatment's results and studies outcome evaluation. TTH: first in prevalence, still highly subdiagnosed. Main clinical presentations: episodic and chronic.

slight female preponderance. Patophysiology and trigger factors: the role of limbic nociceptive system, sedentarism stress and muscular tension.

pharmacological and non-pharmacological. Cluster headache: low prevalence but high daily-living activities impact, effective treatment. Other primary headaches: variability of trigger factors and role of desensitization process.

we remark the complexity of headache and the of physicians' role: to relief patients suffering, throughout a precise diagnosis and treatment.