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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

  • 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


Essentials of Diagnosis

  • 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
    • Traction headache
      • Can be caused by stroke
    • Inflammatory headaches
      • Can be caused by sinus infection with inflammation
      • Increased intracranial pressure

General Considerations

  • 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


Signs and Symptoms

  • 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

Functional Implications

  • 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

Possible Contributing Causes

  • Forward-head, rounded-shoulders posture due to tight pectoralis, weak periscapular, deep neck-flexor muscles.
  • Prolonged position of cervical side-bending towards impaired nerve or prolonged extension
  • Facet hypertrophy
  • Trauma
  • Light
  • Sounds
  • Hydration
  • Nutritional deficiency
  • Vascular insufficiency
  • Muscular tightness
  • Stress

Differential Diagnosis


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