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0:00
Thank you for joining me on
this talk about the classification
of headache disorders.
I'm Dr. Sara Sacco.
I'm a neurologist and
headache specialist
in Charlotte, North Carolina.
0:14
If you want to appropriately
treat a patient,
you really need to know
what it is you're treating.
That goes for chest pain,
abdominal pain, as well as
for headache disorders,
because you treat different
ones differently.
It's important
that we understand
what kind of headache it is
that we're trying to
treat or diagnose.
The International
Headache Society
came up with the classification
of headache disorders,
so that we'd be all
treating the same headache.
The first one was
published back in 1988,
and a group of headache
specialists got together and
came up with what they thought
was the best definition
for headaches.
After that, they reviewed
those definitions
and they looked at validation,
and they got another committee.
This second iteration,
or version, of
the International Classification
of Headache Disorders
was published in 2004.
Working with the second version,
it led to more questions
about the diagnosis
and a need for more validation,
so they got another whole
committee together,
and they came up with
a third version,
which was published in 2018.
That's the classification
I'm going to be using,
and I'm going to be primarily
talking about that ICHD-3.
1:29
It's important to understand
the organization of
how the ICHD-3 works.
They're divided into different
groupings of headaches,
- whether it's primary
or secondary -
within those they have
different groupings,
migraine, and then subgroupings.
That's why you see
that numbering system.
It can go into actually
three or even four digits.
When you look at the
individual ones,
there is typically
something like the number
of headache attacks as
part of the diagnosis.
In addition, there's going to be
certain criteria that
they all need to meet.
What you see on this slide is
the general organization of it.
Probably the most
important one is
the final one on this one.
It's E -
"not better accounted for by
another ICHD-3 diagnosis".
When you're thinking about
these headache diagnoses,
always keep the
differential in mind
so you're not missing
some other diagnosis.
