2018 年 35 巻 4 号 p. 460-463
Secondary headache refers to a headache associated with the underlying disease causing it and is a generic term for headache compared to primary headache where headache itself is disease such as migraine, tension–type headache, and trigeminal autonomic cephalalgia. According to “Clinical Practice Guideline for Chronic Headache 2013”, in the following cases : (1) headache with sudden onset, (2) headache never experienced before, (3) headache different from the customary headache, (4) headache that has increased in frequency and intensity, (5) headache begins after age 50, (6) headache with neurological deficit, (7) headache in a patient with cancer or immunodeficiency, (8) headache in a patient with psychiatric symptoms, (9) headache in a patient with fever, neck stiffness or meningeal irritation, it is recommended that an aggressive search is necessary in doubt of secondary headache.
Recent advances in imaging diagnostic techniques, especially MR imaging, make head and neck MR examinations a powerful tool to advance the differential diagnosis of organic diseases that cause secondary headache. It is important to keep in mind the characteristics and accompanying symptoms of headaches to search.
In everyday headache medical examination, it is important to always pay attention to that secondary headache should not be overlooked.
