Clinical meaning
Primary Headache Disorders involves disruption of neuronal signaling, neurotransmitter balance, or structural integrity within the central or peripheral nervous system. Primary Headache Disorders pathophysiology encompasses mechanisms including excitotoxicity, demyelination, ischemic injury, and neurodegeneration.
Diagnosis & workup
Diagnostics & workup: - EMG/NCS for peripheral neuropathy, radiculopathy, myopathy evaluation - CT head without contrast (acute hemorrhage, mass effect, midline shift) - MRI brain with/without gadolinium (ischemia, demyelination, tumors) - Carotid duplex ultrasound for extracranial stenosis - NIH Stroke Scale (NIHSS) for stroke severity quantification - Mini-Mental State Exam (MMSE) or MoCA for cognitive screening - Glasgow Coma Scale (GCS) for consciousness level assessment
Risk factors: - Diabetes with peripheral and autonomic neuropathy - Age >65 with progressive neurodegenerative risk - Hypertension (leading modifiable risk for stroke) - Sleep deprivation or circadian rhythm disruption - Tobacco use with cerebrovascular disease risk - Genetic mutations (Huntington HTT, APOE4 for Alzheimer's) - Atrial fibrillation with cardioembolic stroke risk