Daily Chronic Headache — Tension Headaches, Migraine, and Combined Headaches: The Transformation Concept

Abstract

This short introduction will emphasize the approach to chronic recurring daily or almost daily headache and it will consider the phenomenon of “migraine transformation” in which episodic and typical primary headache conditions appear to be transformed into chronic daily headache patterns. In 1962, the Ad Hoc Committee on Classification of Headache offered what was to become the standard classification for head pain disorders for the next 20 years. This report was based upon the premise of a clear distinction between migraine and tension headache (TH) and emphasized system-specific etiologies: vasculature in migraine, musculature in tension headache. But, despite its many citations and its traditional acceptance by researchers and clinicians alike, many authorities have been unable to reconcile the myriad of events and phenomena of migraine, TH, and cluster headache with the basic foundations of this classification. During the past few years, the emphasis on peripheral phenomena (blood vessels and muscles) and separateness between migraine and TH disorders has been challenged, and with it has come a change views on the treatment of these disorders.