title: Headache in the elderly: characteristics in a series of 262 patients.
abstract: BACKGROUND
  Although headache prevalence decreases in patients older than 65, headaches are a common complaint and their different clinical and therapeutic features must be understood. This article analyses the clinical characteristics of elderly patients treated in an outpatient headache unit.
  
  
  METHODS
  We collected demographic and clinical data from patients treated in a tertiary hospital headache unit between January 2008 and May 2013. Headaches were codified according to the International Classification of Headache Disorders, 2nd edition (ICHD-2).
  
  
  RESULTS
  Of a total of 1868 patients treated, 262 patients (14%, 189 women and 73 men) were older than 65 years. Ninety-nine (68 women, 31 men, 5.3% of the total) were over 75. Headaches began after the age of 65 in only 136 patients (51.9%). The 362 headaches were codified as follows: 23.8% as Group 1 (Migraine) and 28.7% as Group 2 (Tension-type headache). We diagnosed 58 (16%) secondary headaches; 26 (7.2%) were classified as Group 13 (Cranial neuralgias) and 23 (6.4%) in Group 14 (Other headaches). Symptomatic medication overuse was detected in 38 patients (14.5%). We also identified headaches considered typical in the elderly, including chronic migraine (41 cases), hypnic headache (6), occipital neuralgia (4), SUNCT (2), cervicogenic headache (1), primary cough headache (1), and giant cell arteritis (2).
  
  
  CONCLUSIONS
  Elderly patients were frequently treated in our outpatient headache unit. Tension-type headache was the most common diagnosis in this population. Geriatric headache syndromes such as hypnic headache or occipital neuralgia were also represented in our series.
authors.affiliation: Servicio de Neurología, Hospital Clínico Universitario de Valladolid, Valladolid, España.
authors.forename: M
authors.initials: M
authors.lastname: Ruiz
authors.affiliation: Servicio de Neurología, Hospital Clínico Universitario de Valladolid, Valladolid, España.
authors.forename: M I
authors.initials: MI
authors.lastname: Pedraza
authors.affiliation: Servicio de Neurología, Hospital Clínico Universitario de Valladolid, Valladolid, España.
authors.forename: C
authors.initials: C
authors.lastname: de la Cruz
authors.affiliation: Servicio de Neurología, Hospital Clínico Universitario de Valladolid, Valladolid, España.
authors.forename: J
authors.initials: J
authors.lastname: Barón
authors.affiliation: Servicio de Neurología, Hospital Clínico Universitario de Valladolid, Valladolid, España.
authors.forename: I
authors.initials: I
authors.lastname: Muñoz
authors.affiliation: Servicio de Neurología, Hospital Clínico Universitario de Valladolid, Valladolid, España.
authors.forename: C
authors.initials: C
authors.lastname: Rodríguez
authors.affiliation: Servicio de Neurología, Hospital Clínico Universitario de Valladolid, Valladolid, España.
authors.forename: M
authors.initials: M
authors.lastname: Celorrio
authors.affiliation: Servicio de Neurología, Hospital Clínico Universitario de Valladolid, Valladolid, España.
authors.forename: P
authors.initials: P
authors.lastname: Mulero
authors.affiliation: Servicio de Neurología, Hospital Clínico Universitario de Valladolid, Valladolid, España.
authors.forename: S
authors.initials: S
authors.lastname: Herrero
authors.affiliation: Servicio de Neurología, Hospital Clínico Universitario de Valladolid, Valladolid, España. Electronic address: gueneurol@gmail.com.
authors.forename: A L
authors.initials: AL
authors.lastname: Guerrero
mesh_terms: D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006261:Headache / Q000175:diagnosis / Q000453:epidemiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D008881:Migraine Disorders / Q000453:epidemiology; D013030:Spain / Q000453:epidemiology; D018781:Tension-Type Headache / Q000453:epidemiology
keywords: Cefalea hípnica; Cefalea tensional; Clasificación Internacional de Cefaleas-2; Elderly; Epidemiology; Epidemiología; Hypnic headache; International Classification of Headache Disorders-2; Migraine; Migraña; Personas mayores; Tension-type headache