Table 3 Definition of migraine, tension type-headaches, primary stabbing headaches and thunderclap headaches, according to the International Classification of Headaches Disorders – 3b
From: Sudden onset headaches in paediatric emergency departments: diagnosis and management
MIGRAINE WITHOUT AURA | MIGRAINE WITH AURA |
|---|---|
A. At least five attacks fulfilling criteria B-D B. Headache attacks lasting 2–72 h (untreated or unsuccessfully treated) C. Headache has at least two of the following four characteristics: - unilateral location - pulsating quality - moderate or severe pain intensity - aggravated by or causing avoidance of routine physical activity (e.g. walking or climbing stairs) D. During headache, at least one of the following: - nausea and/or vomiting - photophobia and phonophobia E. Not better accounted for by another ICHD-3 diagnosis. | A. At least two attacks fulfilling criteria B and C B. One or more of the following fully reversible aura symptoms: - Visual - Sensory - speech and/or language - motor - brainstem - retinal C. At least three of the following six characteristics: - at least one aura symptom spreads gradually over ≥ 5 min - two or more aura symptoms occur in succession - each individual aura symptom lasts 5–60 min - at least one aura symptom is unilateral - at least one aura symptom is positive - the aura is accompanied, or followed within 60 min, by headache D. Not better accounted for by another ICHD-3 diagnosis. |
TENSION-TYPE HEADACHES (INFREQUENT) | |
A. At least 10 episodes of headache occurring on < 1 day/month on average (< 12 days/year) and fulfilling criteria B-D B. Lasting from 30 min to 7 days C. At least two of the following four characteristics: - bilateral location - pressing or tightening (non-pulsating) quality - mild or moderate intensity - not aggravated by routine physical activity such as walking or climbing stairs D. Both of the following: - no nausea or vomiting - no more than one of photophobia or phonophobia E. Not better accounted for by another ICHD-3 diagnosis1. | |
CLUSTER HEADACHES and other Trigeminal Autonomic Cephalalgias (TACs) | |
A. At least five attacks fulfilling criteria B-D B. B. Severe or very severe unilateral orbital, supraorbital and/or temporal pain lasting 15–180 min (when untreated) C. C. Either or both of the following: a. at least one of the following symptoms or signs, ipsilateral to the headache: - conjunctival injection and/or lacrimation - nasal congestion and/or rhinorrhoea - eyelid oedema - forehead and facial sweating - miosis and/or ptosis b. a sense of restlessness or agitation D. Occurring with a frequency between one every other day and 8 per day E. Not better accounted for by another ICHD-3 diagnosis. Paroxysmal Hemicrania (compared to cluster headaches): A differs: at least 20 attacks B differs: lasting 2–30 min and occurring several or many times a day C is the same D differs: Occurring with a frequency of > 5 per day E: Prevented by therapeutic doses of indomethacin F: not better accounted by another ICHD-3 diagnosis Short-lasting unilateral neuralgiform headache attacks - SUNCT/SUNA (compared to cluster headaches): A differs: at least 20 attacks B differs: Moderate or severe pain, lasting for 1–600 s C differs: forehead and facial flushing and sensation of fullness in the ear in addition to the above symptoms D differs: Occurring with a frequency of at least one per day E is the same | |
PRIMARY STABBING HEADACHES | THUNDERCLAP HEADACHES |
A. Head pain occurring spontaneously as a single stab or series of stabs and fulfilling criteria B and C B. Each stab lasts for up to a few seconds C. Stabs recur with irregular frequency, from one to many per day D. No cranial autonomic symptoms E. Not better accounted for by another ICHD-3 diagnosis. | A. Severe head pain fulfilling criteria B and C B. Abrupt onset, reaching maximum intensity in < 1 min C. Lasting for ≥ 5 min D. Not better accounted for by another ICHD-3 diagnosis |