[Primary cephaleas. A revision of their diagnosis and therapeutic approach].
This review focuses on primary headaches, its diagnosis and treatment. For the IHS specialists they are: migraine, tension-type headache (TTH), cluster and others. Migraine: the second in prevalence and the first in morbility, clinical features and differences between migraine with (Ma) and without aura (Mo).


BACKGROUND
10% prevalence and 3:1 women to men proportion. Patophysiology: primary central nociception disorder with secondary vascular involvement.


METHODS
specific and non-specific, acute and preventive. Psychiatric disorders and migraine: there is evidence of clinical and pharmacological links, mainly between Ma and several psychiatric disorders. Migraine in childrens: important clinical and therapeutic differences from adult, importance of family approach. Migraine and hormones: the importance of estrogen drop, as trigger factor, treatment. Migraine and epilepsy: both shares neuronal hyperexcitability pattern. Migraine and stroke: vascular and ischemic factors involved. Evidence-based medicine: improves treatment's results and studies outcome evaluation. TTH: first in prevalence, still highly subdiagnosed. Main clinical presentations: episodic and chronic.


BACKGROUND
slight female preponderance. Patophysiology and trigger factors: the role of limbic nociceptive system, sedentarism stress and muscular tension.


METHODS
pharmacological and non-pharmacological. Cluster headache: low prevalence but high daily-living activities impact, effective treatment. Other primary headaches: variability of trigger factors and role of desensitization process.


CONCLUSIONS
we remark the complexity of headache and the of physicians' role: to relief patients suffering, throughout a precise diagnosis and treatment.
Monti
Angel A
AA
Instituto de Neurociencias Córdoba, Argentina. neurocienciascba@agora.com.ar
Rapela
Francisco J
FJ
Bacile Bacile
Elizabeth A
EA
Uberti
Diego
D
D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D003937:Diagnosis, Differential; D005260:Female; D051270:Headache Disorders, Primary / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000628:therapy; D006801:Humans; D008297:Male; D008881:Migraine Disorders / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology; D018781:Tension-Type Headache / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000628:therapy; D051303:Trigeminal Autonomic Cephalalgias / Q000175:diagnosis / Q000209:etiology / Q000628:therapy