[A view on the life course of the most prevalent headache disorders. Spontaneous course, remission, and persistence]

Symptoms and signs of primary headache disorders can change during one's lifetime. Moreover, the impact and the frequency of attacks can fluctuate in an individual patient over time. Before puberty, boys and girls are equally affected; after puberty most headache disorders predominate in women. The treatment of primary headache disorders always has to take into consideration the severity and the frequency of headache attacks as well as the relevant comorbidities. Prophylactic headache treatment can modulate the course of primary headache disorders. Specific prophylactic treatment is the most important instrument for avoiding headache chronification caused by medication overuse. While primary headache disorders tend to improve in elderly patients, secondary headache disorders peak in elderly people. They are often a symptom of oncologic diseases, vascular disorders, or are linked to side effects of drugs that are prescribed more frequently in the elderly. The treatment and the prognosis of secondary headache disorders always depend on the underlying disease.