ICC-3

Secondary Headache

Dr Ehab El Refaee
Assistant Professor of neurosurgery
Learning Objectives

By the end of this session students should be able to:

• Example:
• Describe the approach to diagnose Secondary headache.
Mechanism

Mechanical
Chemoreceptors
Receptors Chemical

-Dura

-Blood vessels
Of the meninges

Stretch
 Tension Headache with pericranial tenderness

Primary Headache?

Trigeminal Autonomic Cephalgia Aura (or without)

(Cluster headache) Recurrent
No intracranial Pathology
Photosensitivity
Nausea
Eye pain
Secondary Headache

Trauma Substance abuse

Abuse
Posttraumatic:
Overuse
Associated with depression

Vascular Diseases
Aneurysms
Hypertension
Temporal arteritis

Intracranial Pathology
Infection

Homeostasis problem
Secondary Headache - Regional

Ophthalmic

Nasal

Ear
TMJ

TGN Cervical
 When To Worry
45 years old male presenting with sudden post coital onset of severe headache that he described to be the worst of his life neurologically intac
with Neck stiffness CT Brain SAH

• Sudden Onset 70 years diabetic old male came presenting with new onset of headache
accompanies with deterioration of vision
• Change in Character
• New Onset in old age
• Associated with other Symptoms
60 years old male presenting with a long history of
• History of Cancer neck pain accompanied by headache now he
developed cervicobrachialgia with worsened
• Immunocompromise headache

40 years old female with history of breast cancer

came presenting with some acute onset of
progressive headache accompanied by nausea and
vomiting.

Five years old child always complaining of headache since two weeks
accompanied with fever and ear discharge
Investigations
According to history
References

https://ichd-3.org/
Thank you