The geriatric headache: a unique clinical ailment

The "geriatric headache" may be a unique clinical ailment. A change in a chronic headache pattern or a new onset headache should raise suspicion immediately in an elderly patient. Temporal arteritis occurs almost exclusively in the elderly population. Because of its grave prognosis and ease of treatment, this condition should always be considered a possibility in the elderly patient with headache. A throbbing non-migranous headache may indicate an impending cerebrovascular event. Other causes of headache, such as mass lesions (tumours, subdural hematomas), drugs (nitrates, estrogens) and depression, take on greater significance in the elderly. While migraine and cluster headaches are more common in young adults, they may begin in older persons; indeed, transient migraine accompaniments are "TIA mimics". The authors hope that this overview of the "geriatric headache" will facilitate early recognition of this ailment which often leads to diagnostic confusion.