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Summary

Headache is one of the most common complains at clinical practice. They can be secondary headaches to a specific disorder as a sinus infection or primary headaches as migraine and tensional-type headaches. Migraine and tension-type headaches have a higher economic burden related to workdays lost. Clinical diagnosis of primary headaches are based on specific criteria done by International Headache Society. Migraine is characterized by a pulsatil pain, generally unilateral, of moderate to severe intensity that aggravates by physical activities. It is accompanied by nausea and/or vomiting and photophobia and phonophobia. Tension-type headaches is characterized by a pressing/tightening pain, generally bilateral, of mild to moderate intensity that do not aggravate by physical activity. Sometimes, the clinical symptoms are not so different between them and some kind of superposition can occur. Migraine treatment has two parts. We have to treat the acute crisis with analgesic medication, antiinflammatory drugs or triptans, a class of drugs especially designed to treat migraines. However, in the patient with very frequent crisis with a high compromised quality of life it is very important to introduce prophylactic medication that improves the frequency and intensity of migraine crisis. The most common used medications are beta-blockers, tricyclic antidepressants and some anticonvulsivants. Treatment of tension-type headaches is based on analgesic medications. In chronic cases, prophylaxis was done using tricyclic medications. It is a very important part of an adequate treatment of primary headaches to clarify patients that although it is impossible to cure headaches definitely, it is possible to control pain with a great improvement in quality of life.



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