HEADACHE

Headaches caused by disorders of the neck has been a controversial subject; some feel that it is, at
best, a rare syndrome. Cluster headache is a primary headache disorder of unclear etiology. It is
more common in males, and is often precipitated by ingestion of alcohol. Not infrequently, the
patient awakes from sleep with the onset of the headache. Patients are typically quite agitated
during the attack, which tends to be relatively brief compared with the time-course of migraine or
tension-type headaches. Cluster headaches may occur on an episodic or chronic basis. Chronic
cluster headache may be primary or a stage evolving from episodic cluster headache

In the International Headache Society (IHS) classification category, headache related to intrathecal
injections is a direct effect of the agent with the following diagnostic criteria:

A. Headache follows intrathecal injection within 4 hours.

B. Headache is diffuse and present also in the recumbent position.
C. Headache clears completely within 14 days. (If it persists, consider post-lumbar puncture.)

if the headache is because of presumed chemical meningitis, the IHS criteria specify the criteria:

A. Headache follows intrathecal injection within 5–72 hours.

B. Headache is diffuse and present also in the recumbent position.
C. Cerebrospinal fluid pleocytosis with negative culture.