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Condition/Disorder Synonyms

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  • Cephalagia

  • Vascular headache

  • Muscular tension/myogenic headache

  • Cervicogenic headache

  • Traction/inflammatory headaches

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ICD-9-CM Codes

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  • 307.81 Tension headache

  • 339 Other headache syndromes

  • 339.0 Cluster headaches and other trigeminal autonomic cephalgias

  • 339.1 Tension type headache

  • 339.2 Post-traumatic headache

  • 339.3 Drug induced headache, not elsewhere classified

  • 339.4 Complicated headache syndromes

  • 339.8 Other specified headache syndromes

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ICD-10-CM Codes

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  • G43 Migraine

  • G44 Cluster headache and other trigeminal autonomic cephalalgias

  • G44.009 Cluster headache syndrome, unspecified, not intractable

  • G44.209 Tension-type headache, unspecified, not intractable

  • G44.309 Post-traumatic headache, unspecified, not intractable

  • G44.41 Drug-induced headache, not elsewhere classified, intractable

  • G44.51 Hemicrania continua

  • G44.80 Other primary headaches

  • G44.81 Hypnic headache

  • G44.82 Headache associated with sexual activity

  • G44.88 Headache attributed to head and or neck trauma

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Preferred Practice Pattern

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Key Features

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Description

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  • Pain in the head or neck region

  • International Classification of Headache Disorders-II (ICDH-II)

    • 13 headache classification groups

  • National Institute of Health (NIH) has 5 classifications of headaches

    • Vascular headache

    • Muscular tension/myogenic headache

    • Cervicogenic headache

    • Traction headaches

    • Inflammatory headaches

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Essentials of Diagnosis

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  • ICDH-II classifications2

    • Primary headaches include migraines, tension headaches, cluster headaches, trigeminal headaches

      • Includes headaches caused by cough, exertion, sexual activity and stabbing

    • Secondary headaches are based upon their etiology: whiplash injury, intracranial headaches, neck injury, vascular disorders

  • NIH Classification3

    • Vascular headache

      • Migraine

      • Cluster headaches

    • Muscular tension/myogenic headache

      • Tension headache

    • Cervicogenic headache

      • Disorder of the cervical spine

    • Traction headache

      • Can be caused by stroke

    • Inflammatory headaches

      • Can be caused by sinus infection with inflammation

      • Increased intracranial pressure

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General Considerations

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  • Headaches can be harmless, disabling, or life threatening

  • Headaches may indicate more severe pathology in the head/brain region

  • Vision and sinus problems can cause headaches

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Demographics

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  • Cluster headaches more common in men than in women

  • Migraine headaches more common in women

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Clinical Findings

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Signs and Symptoms

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  • Migraine

    • Pulsating pain

    • Nausea

    • Sensitivity to light or sound

    • One or both sides of the head

    • Aggravated with routine activity

  • Cluster headaches

    • Severe headaches

    • Short-lasting

    • Symptoms around the eye

  • Toxic headaches

    • Fever

  • Muscular tension/myogenic headache

    • Squeezing or tightening on head

    • Mild to moderate pain

    • Still able to perform routine activity

  • Cervicogenic headache

    • Stiff neck

    • Limited mobility

    • One-sided

    • Pain radiating into arm

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Functional Implications

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  • Difficulty maintaining sitting posture secondary to neck pain

  • Inability to sleep

  • Weakness with upper-extremity lifting

  • Inability to drive or work secondary to light or sound sensitivity

  • Difficulty with neck movements (driving) secondary to pain

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Possible Contributing Causes

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  • Forward-head, rounded-shoulders posture due to tight pectoralis, weak periscapular, deep neck-flexor muscles. ...

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