Skip to main content

Advertisement

Log in

Diagnostic issues in tension-type headache

  • Published:
Current Pain and Headache Reports Aims and scope Submit manuscript

Abstract

The diagnosis of tension-type headache (TTH) is divided into two categories: episodic TTH and chronic TTH. It is important to differentiate TTH from other headaches, including primary and secondary headaches. Significant overlap in the diagnostic criteria makes it difficult to differentiate TTH from other headache disorders and, in particular, migraine. A controversy exists about whether TTH and migraine represent a continuum of the same pathophysiological process.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References and Recommended Reading

  1. Stovner LJ, Hagen K, Jensen R, et al.: The global burden of headache: a documentation of headache prevalence and disability worldwide. Cephalalgia 2007, 27:193–210.

    Article  PubMed  Google Scholar 

  2. Headache Classification Committee of the International Headache Society: The International Classification of Headache Disorders. Cephalalgia 2004, 24(Suppl 1):1–160.

    Google Scholar 

  3. Schoenen J: Differential diagnosis. In The Headaches. Edited by Olesen J, Tfelt-Hansen P, Welch KMA. New York: Raven Press, 1993:509–510.

    Google Scholar 

  4. Lipton RB, Bigal ME, Steiner TJ, et al.: Classification of primary headaches. Neurology 2004, 63:427–435.

    PubMed  CAS  Google Scholar 

  5. Biondi DM: Cervicogenic headache: a review of diagnostic and treatment strategies. JAOA 2005, 105(Suppl 2):S16–S22.

    Google Scholar 

  6. Lenaerts ME, Newman LC: Tension-type headache. In Wolff’s Headache and Other Head Pain, edn 8. Edited by Silberstein SD, Lipton LB, Dodick DW. New York: Oxford University Press; 2008:293–314.

    Google Scholar 

  7. Dworkin SF, LeResche L: Research diagnostic criteria for temporomandibular disorders: review, criteria, examinations and specifications, critique. J Craniomandib Disord 1992, 6:301–355.

    PubMed  CAS  Google Scholar 

  8. Ballegaard V, Thede-Schmidt-Hansen P, Svensson P, Jensen R: Are headache and temporomandibular disorders related? A blinded study. Cephalalgia 2008, 28:832–841.

    Article  PubMed  CAS  Google Scholar 

  9. Jensen R, Rasmussen BK, Pedersen B, Olesen J: Muscle tenderness and pressure pain thresholds in headache. A population-based study. Pain 1993, 52:193–199.

    Article  PubMed  CAS  Google Scholar 

  10. Kaniecki RG, Totten J: Cervicalgia in migraine: prevalence, clinical characteristics, and response to treatment. Poster presented at the 10th IHC. New York; June 29–July 2, 2001.

  11. Zebenholzer K, Wöber-Bingöl Ç: Migrainous disorder and headache of the tension-type not fulfilling the criteria: a follow-up study in children and adolescents. Cephalalgia 2000, 20:611–616.

    Article  PubMed  CAS  Google Scholar 

  12. Turkdogan D, Cagirici S, Soylemez D, et al.: Characteristic and overlapping features of migraine and tension-type headache. Headache 2006, 46:461–468.

    Article  PubMed  Google Scholar 

  13. Smetana GW: The diagnostic value of historical features in primary headache syndromes: a comprehensive review. Arch Intern Med 2000, 160:2729–2737.

    Article  PubMed  CAS  Google Scholar 

  14. Ulrich V, Russell MB, Jensen R, Olesen J: A comparison of tension-type headache in migraineurs and in non-migraineurs: a population-based study. Pain 1996, 67:501–506.

    Article  PubMed  CAS  Google Scholar 

  15. Lipton RB, Cady RK, Stewart SR, et al.: Diagnostic lessons from the spectrum study. Neurology 2002, 58:S27–S31.

    Article  PubMed  CAS  Google Scholar 

  16. Lipton RB, Stewart WF, Cady R, et al.: Sumatriptan for the range of headaches in migraine sufferers: results of the spectrum study. Headache 2000, 40:783–791.

    Article  PubMed  CAS  Google Scholar 

  17. Silberstein SD, Lipton RB, Saper JR: Chronic daily headache including transformed migraine, chronic tension-type headache, and medication overuse headache. In Wolff’s Headache and Other Head Pain, edn 8. Edited by Silberstein SD, Lipton LB, Dodick DW. New York: Oxford University Press, 2008:315–377.

    Google Scholar 

  18. Forsyth PA, Posner JB: Headaches in patients with brain tumors: a study of 111 patients. Neurology 1993, 43:1678–1683.

    PubMed  CAS  Google Scholar 

  19. Headache Classification Committee: New appendix criteria open for a broader concept of chronic migraine. Cephalalgia 2006, 26:742–746.

    Article  Google Scholar 

  20. Bigal ME, Serrano D, Scher A, et al.: Acute migraine medications and evolution from episodic to chronic migraine: a longitudinal population-based study. Wolff Award Presentation at the 50th Annual Scientific Meeting of the AHS. Boston, MA; June 26–29, 2008.

  21. Headache Classification Committee of the International Headache Society: Classification and diagnostic criteria for headache disorders, cranial neuralgias and facial pain. Cephalalgia 1988, 8(Suppl 7):1–96.

    Google Scholar 

  22. Sanin LC, Mathew NT, Bellmyer LR, Ali S: The International Headache Society (IHS) headache classification as applied to a headache clinic population. Cephalalgia 1994, 14:443–446.

    Article  PubMed  CAS  Google Scholar 

  23. Manzoni GC, Granella F, Sandrini G, et al.: Classification of chronic daily headache by International Headache Society criteria: limits and new proposals. Cephalalgia 1995, 15:37–43.

    Article  PubMed  CAS  Google Scholar 

  24. Koenig MA, Gladstein J, McCarter RJ, et al.: Chronic daily headache in children and adolescents presenting to tertiary headache clinics. Headache 2002, 42:491–500.

    Article  PubMed  Google Scholar 

  25. Cady RK: The Convergence Hypothesis. Headache 2007, 47(Suppl 1):S44–S51.

    Article  PubMed  Google Scholar 

  26. Laurell K, Larsson B, Nattsson P, Eeg-Olofsson O: A 3-year follow-up of headache diagnoses and symptoms in Swedish schoolchildren. Cephalalgia 2006, 26:809–815.

    Article  PubMed  CAS  Google Scholar 

  27. Mathew NT, Reuveni U, Perez F: Transformed or evolutional migraine. Headache 1987, 27:102–106.

    Article  PubMed  CAS  Google Scholar 

  28. Manzoni GC, Micieli G, Granella F, et al.: Daily chronic headache: classification and clinical features: observation on 250 patients. Cephalalgia 1987, 7(Suppl 6):169–170.

    Google Scholar 

  29. Manzoni GC, Sandrini G, Zanferrari C, et al.: Clinical features of daily chronic headache and its different subtypes. Cephalalgia 1991, 11(Suppl 11):292–293.

    Google Scholar 

  30. Krymchantowski AV: Primary headache diagnosis among chronic daily headache patients. Arq Neuropsiquiatr 2003, 61(2B):364–367.

    PubMed  Google Scholar 

  31. Silberstein SD, Lipton RB, Sliwinski M: Classification of daily and near-daily headache: field trial of revised IHS criteria. Neurology 1996, 47:871–875.

    PubMed  CAS  Google Scholar 

  32. Fumal A, Schoenen J: Tension-type headache: current research and clinical management. Lancet Neurol 2008, 7:70–83.

    Article  PubMed  CAS  Google Scholar 

  33. Ashina S, Bendtsen L, Ashina M, et al.: Generalized hyperalgesia in patients with chronic tension-type headache. Cephalalgia 2006, 26:940–948.

    Article  PubMed  CAS  Google Scholar 

  34. Bendtsen L: Central sensitization in tension-type headache: possible pathophysiological mechanisms. Cephalalgia 2000, 20:486–508.

    Article  PubMed  CAS  Google Scholar 

  35. Ashina M: Neurobiology of chronic tension-type headache. Cephalalgia 2004, 24:161–172.

    Article  PubMed  CAS  Google Scholar 

  36. Ashina M, Bendtsen L, Jensen R, et al.: Possible mechanisms of action of nitric oxide synthase inhibitors in chronic tension-type headache. Brain 1999, 122:1629–1635.

    Article  PubMed  Google Scholar 

  37. Ashina M, Bendtsen L, Hensen R, Olesen J: Nitric oxideinduced headache in patients with chronic tension-type headache. Brain 2000, 123:1830–1837.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Sara Sacco.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Sacco, S. Diagnostic issues in tension-type headache. Current Science Inc 12, 437–441 (2008). https://doi.org/10.1007/s11916-008-0074-6

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11916-008-0074-6

Keywords

Navigation