Headache from a Neuro-Ophthalmic point of view

Abstract

Headache is the most frequent cause for cooperative interaction between neurologists and ophthalmologists. Frequently, patients are seen first by their primary care physicians, and are then referred to ophthalmologists for further testing and management, chiefly to rule out ocular sources of pain. From there, they are commonly referred to neurologists, to be sure that something serious will not be missed. The diagnostic classification of headache is at first glance extraordinarily confusing or overwhelming, considering that the International Headache Society (IHS) has defined 176 different types of headache. This large number can be reduced to a more manageable level, since 90% of all primary headache syndromes are attributable to the two most common types, migraine and tension headache. The fact that there is no clearly defined system that allows for rapid classification of headache, especially cases of primary headache, underscores the importance of a carefully taken history and clinical examination.