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Chronic Headache

If your headaches occur on a daily basis, at least 15 days a month for 3 months, and is not associated with any underlying cause, you may have a condition called chronic daily headaches (CDH).

Types

Chronic daily headaches may present as different types of headaches and are usually classified as:

Short duration (less than 4 hours) CDH: rare and includes:

  • Cluster headaches: intense pain from neck to temple and around the eye, on one side of the face, mostly at night

Long duration (more than 4 hours) CDH: more common and includes:

  • Chronic tension-type headaches: mild to moderate pain present on both sides of the head; develops from episodic tension-type headaches
  • Chronic migraine headaches: throbbing pain on one side of the head with associated symptoms such as light sensitivity and nausea, but lacking aura symptoms
  • Hemicrania continua: persistent pain that peaks in severity
  • New daily persistent headache: mild to moderate pain present on both sides of the head, with no past history of headaches

Causes

The cause of chronic daily headache is unknown but could be due to an abnormal development of low pain threshold or lack of pain suppression in the brain.

Diagnosis

To diagnose your headache, your doctor will review your medical history and perform a physical examination to define the type of headache and possible causes. You may need to undergo CT and MRI testing to look for abnormalities, blood and urine tests, or electroencephalography to study the electrical activity of the brain.

Treatment

In the absence of secondary causes, your doctor will focus treatment on preventing headaches. You may be prescribed antidepressants, anti-seizure medications, NSAIDs and blood pressure medication. Relaxation therapy may be recommended and botulinum toxin (Botox) injections may be given.

For regional head pain we offer:

  • Head/Facial Injections with image guidance (Fluoro, U/S, or CT) targeting:
    • Greater/Lesser occipital nerves
    • Trigeminal V nerve branches (SON, STN, ATN)
    • Glossopharyngeal nerve
    • Sphenopalatine ganglion
    • Trigeminal (Gasserian) Ganglion
    • Third Occipital Nerve (TON)
  • Ablation (GON, Central C2 ganglia)
  • Neuromodulation