cefaleia

Cefaleia, commonly referred to as headache, is a pain or discomfort in the head or face. It is one of the most frequent clinical complaints and a symptom that can reflect a wide range of conditions. Headache disorders are broadly divided into primary headaches, where the headache itself is the main problem, and secondary headaches, where the pain signals another condition.

Primary headaches include tension-type headaches, migraines, and cluster headaches. Tension-type headaches present as a bilateral, pressing or tightening pain of mild to moderate intensity, often associated with muscle tension in the neck and scalp. Migraines are typically episodic and can be unilateral, throbbing, and associated with nausea, light or sound sensitivity, and occasionally aura. Cluster headaches are severe, strictly unilateral attacks around the eye or temple, occurring in clusters with autonomic symptoms.

Secondary headaches arise from another medical issue, such as head injury, infection, hemorrhage, vascular disorders, medication overuse, sinus disease, or metabolic disturbances. Red flags suggesting a secondary cause include sudden onset, very new or progressively worsening headache, neurological symptoms, fever, neck stiffness, or confusion.

Diagnosis relies mainly on history and examination. Imaging or laboratory testing is guided by red flags or suspected secondary etiologies. Treatment focuses on symptom relief, prevention of recurrence for recurrent disorders, and management of any underlying condition. Acute strategies for migraine and tension-type headaches include analgesics, NSAIDs, and triptans where appropriate; preventive therapies may involve lifestyle changes and, for some patients, medications such as beta-blockers, anticonvulsants, or antidepressants. Avoidance of medication overuse is important.

Prognosis varies; most primary headaches are manageable with appropriate strategies, though some individuals experience chronic symptoms requiring ongoing care.