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Tertiary Healthcare System

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Primary stabbing headache in a tertiary headache centre.

Simone Braca1, Amy Gimson1, Peter J Goadsby2,3,4

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Primary stabbing headache (PSH) frequently co-occurs with migraine, suggesting shared biological pathways. This close link indicates that migraine may facilitate PSH, warranting further investigation into their underlying mechanisms.

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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.