Primary stabbing headache in a tertiary headache centre.

Area of Science:

• Neurology
• Headache Medicine

Background:

• Primary stabbing headache (PSH) is a common, short-lasting head pain of unknown cause.
• PSH often coexists with other primary headache disorders, particularly migraine, hinting at shared pathophysiology.

Purpose of the Study:

• To investigate the comorbidity of PSH with other primary headache disorders.
• To explore the potential shared biological mechanisms between PSH and migraine.

Main Methods:

• Retrospective analysis of 68 PSH patients diagnosed between 2018-2025.
• Systematic literature search (PubMed/MEDLINE, EMBASE) following PRISMA guidelines.
• Analysis of demographic data and co-occurring headache disorders.

Main Results:

• 90% of PSH patients had a concomitant migraine diagnosis.
• Literature review confirmed significant PSH-migraine co-occurrence (over two-thirds of cases).
• PSH occurred in 36-41% of hemicrania continua and 2-33% of cluster headache cases, but TACs were infrequent in PSH cohorts.

Conclusions:

• PSH and migraine are closely linked, likely sharing overlapping pathophysiological pathways.
• Migraine biology may facilitate PSH development.
• Further research into molecular mechanisms is needed for targeted therapies.