Differential diagnosis of tension headache and basic principles of treatment

Abstract

Headache (cephalalgia) is one of the most common symptoms and is a manifestation of more than 50 diseases. According to the World Health Organization, at least one episode of headache during a lifetime has occurred in almost every inhabitant of the Earth, and about half of them noted periodic headaches. In its etiology, cephalalgia can be primary, not associated with organic damage to tissues and organs, and secondary, which is based on pathological changes. In particular, cephalalgia in inflammatory lesions of the paranasal sinuses, brain tumors, encephalitis and meningitis, acute cerebrovascular accident, head trauma, arterial hypertension, aneurysm of the cerebral vessels, etc., should be attributed to the secondary headache. In 95–97 % of cases, the headache is not based on organic lesion, and in this case, the headache is primary. Primary cephalalgia can be based on both vegetative-vascular and metabolic-destructive changes. Primary headache can be noted with emotional or physical overstrain, exposure to a number of light, sound or olfactory stimuli, liquorodynamic or dysmetabolic disorders, when taking certain medications. Conventionally, primary headache can be divided into three groups — tension headache, migraine and cluster headache.