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Gago-Veiga, D. García-Azorín, N. Mas-Sala, C.M. Ordás, M. Ruiz-Piñero, M. Torres-Ferrús, S. Santos-Lasaosa, J. Viguera Romero, P. Pozo-Rosich" "autores" => array:9 [ 0 => array:2 [ "nombre" => "A.B." "apellidos" => "Gago-Veiga" ] 1 => array:2 [ "nombre" => "D." "apellidos" => "García-Azorín" ] 2 => array:2 [ "nombre" => "N." "apellidos" => "Mas-Sala" ] 3 => array:2 [ "nombre" => "C.M." "apellidos" => "Ordás" ] 4 => array:2 [ "nombre" => "M." "apellidos" => "Ruiz-Piñero" ] 5 => array:2 [ "nombre" => "M." "apellidos" => "Torres-Ferrús" ] 6 => array:2 [ "nombre" => "S." "apellidos" => "Santos-Lasaosa" ] 7 => array:2 [ "nombre" => "J." "apellidos" => "Viguera Romero" ] 8 => array:2 [ "nombre" => "P." 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Pozo-Rosich" "autores" => array:9 [ 0 => array:4 [ "nombre" => "A.B." "apellidos" => "Gago-Veiga" "email" => array:1 [ 0 => "dra.anagago@gmail.com" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "D." "apellidos" => "García-Azorín" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 2 => array:3 [ "nombre" => "N." "apellidos" => "Mas-Sala" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] ] ] 3 => array:3 [ "nombre" => "C.M." "apellidos" => "Ordás" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">d</span>" "identificador" => "aff0020" ] ] ] 4 => array:3 [ "nombre" => "M." "apellidos" => "Ruiz-Piñero" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 5 => array:3 [ "nombre" => "M." "apellidos" => "Torres-Ferrús" "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">e</span>" "identificador" => "aff0025" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">f</span>" "identificador" => "aff0030" ] ] ] 6 => array:3 [ "nombre" => "S." "apellidos" => "Santos-Lasaosa" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">g</span>" "identificador" => "aff0035" ] ] ] 7 => array:3 [ "nombre" => "J." "apellidos" => "Viguera Romero" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">h</span>" "identificador" => "aff0040" ] ] ] 8 => array:3 [ "nombre" => "P." "apellidos" => "Pozo-Rosich" "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">e</span>" "identificador" => "aff0025" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">f</span>" "identificador" => "aff0030" ] ] ] ] "afiliaciones" => array:8 [ 0 => array:3 [ "entidad" => "Unidad de Cefaleas, Servicio de Neurología, Instituto de Investigación Sanitaria Princesa, Hospital Universitario de la Princesa, Madrid, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Unidad de Cefaleas, Hospital Clínico Universitario de Valladolid, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Servicio de Neurología, Hospital Universitario Sant Joan de Déu, Fundación Althaia, Manresa, Barcelona, Spain" "etiqueta" => "c" "identificador" => "aff0015" ] 3 => array:3 [ "entidad" => "Servicio de Neurología, Hospital Universitario Rey Juan Carlos, Móstoles, Madrid, Spain" "etiqueta" => "d" "identificador" => "aff0020" ] 4 => array:3 [ "entidad" => "Unidad de Cefalea, Servicio de Neurología, Hospital Universitari Vall d’Hebron, Barcelona, Spain" "etiqueta" => "e" "identificador" => "aff0025" ] 5 => array:3 [ "entidad" => "Grupo de Investigación en Cefalea, VHIR, Universitat Autònoma Barcelona, Spain" "etiqueta" => "f" "identificador" => "aff0030" ] 6 => array:3 [ "entidad" => "Unidad de Cefaleas – Servicio de Neurología, Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain" "etiqueta" => "g" "identificador" => "aff0035" ] 7 => array:3 [ "entidad" => "Unidad Gestión Clínica de Neurología, Hospital Virgen Macarena, Sevilla, Spain" "etiqueta" => "h" "identificador" => "aff0040" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Cómo y cuándo derivar un paciente con cefalea primaria y neuralgia craneofacial desde Urgencias y Atención Primaria: recomendaciones del Grupo de Estudio de Cefalea de la Sociedad Española de Neurología" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 1372 "Ancho" => 1667 "Tamanyo" => 153934 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Differentiating characteristics of the various trigeminal autonomic cephalalgias.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0055">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">The Spanish Society of Neurology's Headache Study Group (GECSEN) has detected that patients are attending consultation for headache without having undergone the necessary complementary tests or followed the appropriate care circuits, and are sometimes referred at an inopportune time or without the necessary level of urgency/priority.</p><p id="par0010" class="elsevierStylePara elsevierViewall">We have therefore drafted a series of consensus recommendations based on published scientific evidence and our own experience, establishing protocols for the referral of patients with primary headache and/or craniofacial neuralgias from emergency or primary care (PC) departments. These recommendations are general and will require adaptation to the specific circumstances of each centre.</p><p id="par0015" class="elsevierStylePara elsevierViewall">These are practical guidelines addressing differential diagnosis, studies to be requested, and how/when to refer. For a more detailed study of the different types of headache, we recommend consulting GECSEN's Official Clinical Practice Guidelines for Headache,<a class="elsevierStyleCrossRef" href="#bib0175"><span class="elsevierStyleSup">1</span></a> which is available online at the study group's webpage (gecsen.sen.es).</p><p id="par0020" class="elsevierStylePara elsevierViewall">These guidelines were drafted with the collaboration of young neurologists with experience in treating headaches. For practical reasons, the recommendations are divided into 2 publications: the present work, focusing on primary headache and craniofacial neuralgias, and another which addresses secondary headache and neuralgias.</p><p id="par0025" class="elsevierStylePara elsevierViewall">The primary headaches addressed are: migraine, tension-type headaches, trigeminal autonomic cephalalgias, cough headaches, exercise headaches, headaches associated with sexual activity, stabbing headaches, nummular headaches, hypnic headaches, new daily persistent headaches, and craniofacial neuralgias. We present each type of headache, with a brief description of the diagnostic criteria according to the International Headache Society's International Classification of Headache Disorders (ICHD-3 beta),<a class="elsevierStyleCrossRef" href="#bib0180"><span class="elsevierStyleSup">2</span></a> the most important differential diagnoses to be considered, and tables illustrating the protocols for action and referral from emergency departments and PC.</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0060">Recommendations</span><p id="par0030" class="elsevierStylePara elsevierViewall">The most important task when assessing patients with headache, whether in PC or at the emergency department, is to confirm that the patient has no alarm symptoms (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>). Following this, we can continue assessing the patient and determining how to approach treatment.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Migraine with and without aura</span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Episodic migraine</span><p id="par0035" class="elsevierStylePara elsevierViewall">According to the IHCD-3 beta criteria, episodic migraine is a recurring headache with episodes lasting 4-72<span class="elsevierStyleHsp" style=""></span>hours, and is unilateral, pulsatile, of moderate or severe intensity, aggravated by physical activity, and associated with nausea/vomiting and/or photo- or phonophobia, and manifests on fewer than 15 days per month.<a class="elsevierStyleCrossRef" href="#bib0180"><span class="elsevierStyleSup">2</span></a> Status migrainosus is defined as a migraine attack lasting more than 72<span class="elsevierStyleHsp" style=""></span>hours and which is refractory to intravenous pharmacological treatment.<a class="elsevierStyleCrossRef" href="#bib0180"><span class="elsevierStyleSup">2</span></a> Symptoms may or may not be associated with the presence of aura. The following are grounds to suspect atypical aura: sudden onset, predominance of symptoms of motor involvement (hemiparesis) or negative visual symptoms (loss of sight/hemianopsia), duration greater than 60<span class="elsevierStyleHsp" style=""></span>min, first episode suggestive of aura but not accompanied by headache or visual symptoms, first episode at later ages (>50), history of vascular risk factors and/or absence of a family history of migraine (<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>).<a class="elsevierStyleCrossRefs" href="#bib0175"><span class="elsevierStyleSup">1–6</span></a> Patients attending the emergency department for headaches may present a wide range of visual symptoms; both neurological and ophthalmic pathologies must be ruled out (<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>).</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><elsevierMultimedia ident="tbl0010"></elsevierMultimedia></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Chronic migraine</span><p id="par0040" class="elsevierStylePara elsevierViewall">A headache manifesting 15 or more days per month for over 3 months, showing characteristics of migraine headache with or without aura on at least 8<span class="elsevierStyleHsp" style=""></span>days/month. The patient may also meet diagnostic criteria for medication-overuse headache.<a class="elsevierStyleCrossRef" href="#bib0180"><span class="elsevierStyleSup">2</span></a> It is very important to consider modifiable risk factors for transformation to chronic migraine, such as overuse of analgesics or caffeine, mood disorders, sleep apnoea, hormonal disorders, or overweight and obesity (<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>).<a class="elsevierStyleCrossRef" href="#bib0175"><span class="elsevierStyleSup">1</span></a></p></span></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Tension-type headache</span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Episodic tension-type headache</span><p id="par0045" class="elsevierStylePara elsevierViewall">Headache manifesting fewer than 15 days per month, which is bilateral, oppressive, of mild to moderate intensity, lasts from minutes to days, is not aggravated by physical activity, and which may be associated with mild nausea or photo- or phonophobia (<a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>).<a class="elsevierStyleCrossRef" href="#bib0180"><span class="elsevierStyleSup">2</span></a></p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Chronic tension-type headache</span><p id="par0050" class="elsevierStylePara elsevierViewall">Headache with the characteristics described above, but presenting on 15 or more days per month, for over 3 months (<a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>).<a class="elsevierStyleCrossRef" href="#bib0180"><span class="elsevierStyleSup">2</span></a></p></span></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Trigeminal autonomic cephalalgias</span><p id="par0055" class="elsevierStylePara elsevierViewall">Trigeminal autonomic cephalalgias (TACs) are a group of conditions which typically cause a very intense, unilateral pain associated with ipsilateral autonomic symptoms in the face. Symptoms include tearing, conjunctival hyperaemia, ptosis, miosis, rhinorrhoea, a sensation of nasal congestion, perspiration, rubefaction, and a sensation of the ears being blocked. Another characteristic symptom may be anxiety during the episode, particularly in cluster headaches.<a class="elsevierStyleCrossRefs" href="#bib0180"><span class="elsevierStyleSup">2,7</span></a> All types of TAC present as attacks alternating with periods of remission, with the exception of chronic forms and hemicrania continua, in which there is a persistent, hemicranial background pain.</p><p id="par0060" class="elsevierStylePara elsevierViewall">The group includes various conditions which are clinically differentiated by the duration and frequency of episodes, with each condition showing a specific response to different treatments.<a class="elsevierStyleCrossRef" href="#bib0210"><span class="elsevierStyleSup">8</span></a> This group also includes headaches: short-lasting unilateral neuralgiform headache,<a class="elsevierStyleCrossRefs" href="#bib0215"><span class="elsevierStyleSup">9–11</span></a> paroxysmal hemicrania,<a class="elsevierStyleCrossRefs" href="#bib0230"><span class="elsevierStyleSup">12,13</span></a> cluster headache,<a class="elsevierStyleCrossRef" href="#bib0240"><span class="elsevierStyleSup">14</span></a> and hemicranea continua<a class="elsevierStyleCrossRefs" href="#bib0245"><span class="elsevierStyleSup">15,16</span></a> (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>).</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0065" class="elsevierStylePara elsevierViewall">These conditions are so disabling that an “open doors” approach is recommended for these patients, as early intervention at the beginning of a new period of episodes can prevent it from becoming chronic and improve the patient's quality of life.</p><p id="par0070" class="elsevierStylePara elsevierViewall">Although they are considered to be primary headaches, in all TACs, cases have been described with symptoms such as trigeminal vascular compression in SUNCT.<a class="elsevierStyleCrossRef" href="#bib0215"><span class="elsevierStyleSup">9</span></a> In new-onset headache, generally associated with other neurological symptoms, there are published cases of such vascular pathologies as dissection and perivascular tumours, sinusitis, pituitary gland tumours, sinus thrombosis, vascular fistulas, and ophthalmic pathologies (<a class="elsevierStyleCrossRef" href="#tbl0020">Table 4</a>).</p><elsevierMultimedia ident="tbl0020"></elsevierMultimedia></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Other primary headaches</span><p id="par0075" class="elsevierStylePara elsevierViewall">This group is heterogeneous. In a patient's first episode, urgent neuroimaging study is recommended in order to rule out severe secondary headache. Patients attending consultation for recurring episodes and not presenting alarm signs can be prioritised for neurology studies (<a class="elsevierStyleCrossRef" href="#tbl0025">Table 5</a>).</p><elsevierMultimedia ident="tbl0025"></elsevierMultimedia><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Primary cough headache</span><p id="par0080" class="elsevierStylePara elsevierViewall">A primary headache caused by coughing, with no other intracranial structural abnormalities. People aged below 40 are rarely affected. It predominantly affects men, and is responsive to indomethacin. Duration is short (seconds to minutes), with onset immediately or a few seconds after coughing or other Valsalva manoeuvres, such as when lifting weights. It is typically bilateral and occipital or frontal, acute with moderate to severe intensity, and stabbing or explosive (<a class="elsevierStyleCrossRef" href="#tbl0030">Table 6</a>).<a class="elsevierStyleCrossRefs" href="#bib0180"><span class="elsevierStyleSup">2,17</span></a></p><elsevierMultimedia ident="tbl0030"></elsevierMultimedia><p id="par0085" class="elsevierStylePara elsevierViewall">Headache triggered by coughing is secondary in 20% of cases, typically caused by Chiari malformation type 1 or posterior fossa lesions.<a class="elsevierStyleCrossRefs" href="#bib0260"><span class="elsevierStyleSup">18,19</span></a></p></span><span id="sec0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">Primary exercise headache</span><p id="par0090" class="elsevierStylePara elsevierViewall">Pain is triggered by intense and/or prolonged physical exercise. Young men with migraine are predominantly affected. Headache occurs at peak of exercise and remits with rest. Pain is typically pulsatile or stabbing, lasting less than 48<span class="elsevierStyleHsp" style=""></span>hours, and may be accompanied by migraine symptoms.<a class="elsevierStyleCrossRefs" href="#bib0180"><span class="elsevierStyleSup">2,17</span></a></p><p id="par0095" class="elsevierStylePara elsevierViewall">In 80% of cases, recurrent headaches associated with exercise are primary.<a class="elsevierStyleCrossRef" href="#bib0255"><span class="elsevierStyleSup">17</span></a> Cardiac ischaemia (cardiac cephalalgia) must be ruled out in older patients and patients with cardiovascular risk factors or a history of ischaemic heart disease.<a class="elsevierStyleCrossRef" href="#bib0270"><span class="elsevierStyleSup">20</span></a> Cases have been described of exercise headaches secondary to pheochromocytoma, intracranial hyper- or hypotension, or venous sinus thrombosis; clinical judgement should determine the need for investigation.<a class="elsevierStyleCrossRef" href="#bib0260"><span class="elsevierStyleSup">18</span></a></p></span><span id="sec0065" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0115">Primary headache associated with sexual activity</span><p id="par0100" class="elsevierStylePara elsevierViewall">Headache occurs only during sexual activity. Location is occipital and bilateral; pain is intense and occurs at climax or as sexual excitement increases, improving when the activity stops (within 24<span class="elsevierStyleHsp" style=""></span>h). It typically occurs in middle-aged adults, predominantly in men, and co-presents with migraine.<a class="elsevierStyleCrossRefs" href="#bib0180"><span class="elsevierStyleSup">2,17</span></a></p><p id="par0105" class="elsevierStylePara elsevierViewall">Primary sexual headache is usually recurrent. Cases have been described of sexual headache secondary to subarachnoid haemorrhage, arterial dissection, reversible cerebral vasoconstriction syndrome, or arterial hypertension. These conditions should particularly be suspected in women, people older than 40-50 years, and patients with prolonged episodes, loss of consciousness, or nuchal rigidity.<a class="elsevierStyleCrossRefs" href="#bib0260"><span class="elsevierStyleSup">18,19</span></a></p></span><span id="sec0070" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0120">Primary thunderclap headache</span><p id="par0110" class="elsevierStylePara elsevierViewall">Clinical presentation is similar to that of aneurysm rupture, and occurs repetitively without the presence of any intracranial structural lesion. Onset is sudden, reaching maximum intensity in less than 60<span class="elsevierStyleHsp" style=""></span>seconds, and can last hours or even weeks. Pain is spontaneous or triggered by exercise, sexual activity, or hyperventilation. Location is typically occipital; headache may be accompanied by nausea and vomiting.<a class="elsevierStyleCrossRefs" href="#bib0180"><span class="elsevierStyleSup">2,17</span></a></p><p id="par0115" class="elsevierStylePara elsevierViewall">Evaluation of potential secondary causes must be swift and exhaustive; it is essential to rule out intracerebral haemorrhage, subarachnoid haemorrhage, cerebral venous thrombosis, vascular malformations, arterial dissection, reversible cerebral vasoconstriction syndrome, pituitary apoplexy, meningitis, colloid cyst of the third ventricle, CSF hypotension, and acute sinusitis.<a class="elsevierStyleCrossRefs" href="#bib0265"><span class="elsevierStyleSup">19,21</span></a></p></span><span id="sec0075" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0125">Primary stabbing headache</span><p id="par0120" class="elsevierStylePara elsevierViewall">Headache takes the form of transitory stabs of pain, short in duration (seconds), with irregular frequency (one or multiple per day) and variable cranial location, and is not accompanied by autonomic symptoms.<a class="elsevierStyleCrossRefs" href="#bib0180"><span class="elsevierStyleSup">2,17</span></a> The condition is common, predominantly affecting young women, and co-presents with migraine.<a class="elsevierStyleCrossRefs" href="#bib0275"><span class="elsevierStyleSup">21,22</span></a></p><p id="par0125" class="elsevierStylePara elsevierViewall">Main differential diagnosis should consider other primary headaches, such as SUNCT, paroxysmal hemicrania, and trigeminal neuralgia.<a class="elsevierStyleCrossRef" href="#bib0255"><span class="elsevierStyleSup">17</span></a></p></span><span id="sec0080" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0130">Nummular headache</span><p id="par0130" class="elsevierStylePara elsevierViewall">Cranial pain in a fixed, sharply contoured, circular or oval area, measuring 1-6<span class="elsevierStyleHsp" style=""></span>cm in diameter. Pain is oppressive or stabbing, mild to moderate in intensity and associated with intense paroxysms. Half of patients show some kind of sensory alteration (allodynia, hypoaesthesia, paraesthesia), or even dermatologic alterations (alopecia, change in hair colour, or skin atrophy). Around 10% of patients have a history of local trauma. Nummular headache can occur at any age and affects women more than men.<a class="elsevierStyleCrossRef" href="#bib0285"><span class="elsevierStyleSup">23</span></a></p><p id="par0135" class="elsevierStylePara elsevierViewall">Secondary cases have been described due to: fusiform aneurysm of a branch of the superficial temporal artery, cranial fibrous dysplasia, Paget disease, meningioma, arachnoid cysts, insect bites, and pituitary adenoma resection.<a class="elsevierStyleCrossRefs" href="#bib0290"><span class="elsevierStyleSup">24,25</span></a></p></span><span id="sec0085" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0135">Hypnic headache</span><p id="par0140" class="elsevierStylePara elsevierViewall">This condition is uncommon, typically presents at older ages and predominantly in women, and is mainly characterised by occurring exclusively during sleep. Patients typically experience one attack per night, lasting from 15<span class="elsevierStyleHsp" style=""></span>minutes to 4<span class="elsevierStyleHsp" style=""></span>hours, 10 or more nights per month; pain commonly occurs at the same time every night (mainly between 2 and 4<span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleSmallCaps">am</span>). Patients report a moderate, dull pain which is frontotemporal and bilateral or holocranial. It can be associated with mild vegetative symptoms (nausea). Patients often respond to pain by occupying themselves with some peaceful activity, unlike with migraine (where they tend to seek rest) and TACs (which are generally accompanied by agitation).<a class="elsevierStyleCrossRef" href="#bib0180"><span class="elsevierStyleSup">2</span></a></p><p id="par0145" class="elsevierStylePara elsevierViewall">Cases have been described of hypnic headache secondary to posterior fossa or brainstem lesions (meningioma, cerebellar haemangioblastoma) and pituitary gland lesions (non-functioning pituitary macroadenoma), sleep apnoea-hypopnoea syndrome (SAHS), nocturnal arterial hypertension, withdrawal from such drugs as lithium or ACE inhibitors, or symptomatic medication overuse.<a class="elsevierStyleCrossRefs" href="#bib0300"><span class="elsevierStyleSup">26–28</span></a></p></span><span id="sec0090" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0140">New persistent daily headache</span><p id="par0150" class="elsevierStylePara elsevierViewall">Headache occurs every day from onset, for at least 3 months. Patients very frequently remember the precise day and circumstances of pain onset, although it is possible in fewer than half of cases to identify a trigger (infection, stressful event, surgery, substance exposure). Semiological characteristics are not relevant in defining this type of headache. It is more common in women, and can manifest at any age, particularly in the second and third decades of life.</p><p id="par0155" class="elsevierStylePara elsevierViewall">It is essential to rule out secondary causes, such as intracranial hypertension (idiopathic or secondary) or CSF hypotension, overuse of symptomatic medication, chronic meningitis, chronic subdural haematoma, cervical artery dissection, cerebral venous thrombosis, arteriovenous malformation, dural arteriovenous fistula, giant cell arteritis, and cervicogenic headache.<a class="elsevierStyleCrossRefs" href="#bib0265"><span class="elsevierStyleSup">19–31</span></a></p></span></span><span id="sec0095" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0145">Craniofacial neuralgias</span><p id="par0160" class="elsevierStylePara elsevierViewall">Neuralgias have been described both in the main nerve trunks and in the terminal branches of these nerves.<a class="elsevierStyleCrossRef" href="#bib0175"><span class="elsevierStyleSup">1</span></a></p><span id="sec0100" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0150">Trigeminal neuralgia</span><p id="par0165" class="elsevierStylePara elsevierViewall">This is the most frequent type of neuralgia.<a class="elsevierStyleCrossRef" href="#bib0330"><span class="elsevierStyleSup">32</span></a> It is characterised by brief (less than 2<span class="elsevierStyleHsp" style=""></span>minutes), very intensely painful, stabbing or electric-shock-like paroxysms, triggered by stimuli including chewing or local palpation.<a class="elsevierStyleCrossRef" href="#bib0180"><span class="elsevierStyleSup">2</span></a> There is usually a refractory period during which a new attack cannot be triggered. The second and third branches are most frequently affected, with first branch involvement being very rare (<5%).<a class="elsevierStyleCrossRef" href="#bib0175"><span class="elsevierStyleSup">1</span></a></p><p id="par0170" class="elsevierStylePara elsevierViewall">Classic trigeminal neuralgia accounts for 90% of cases, and is caused by a vascular kink compressing the nerve root.<a class="elsevierStyleCrossRef" href="#bib0175"><span class="elsevierStyleSup">1</span></a> In cases where exploration reveals alterations such as local hypoaesthesia, abolished corneal reflex, or alterations in other cranial nerves, secondary causes (slow-growing tumours, cranial base abnormalities, vascular malformations, demyelinating lesions, or brainstem stroke) should be suspected.<a class="elsevierStyleCrossRef" href="#bib0175"><span class="elsevierStyleSup">1</span></a></p><p id="par0175" class="elsevierStylePara elsevierViewall">Neuralgia has been described in the terminal branch of the trigeminal nerve, with a burning, stinging pattern of pain. These are supra- and infraorbital neuralgia, mental nerve neuralgia, nasociliary neuralgia, auriculotemporal neuralgia, supra- and infratrochlear neuralgia and lacrimal neuralgia. The possibility of tumoural aetiology should be accounted for, particularly in the case of mental and infraorbital nerve involvement, (numb chin and numb cheek syndrome, respectively).<a class="elsevierStyleCrossRef" href="#bib0335"><span class="elsevierStyleSup">33</span></a></p></span><span id="sec0105" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0155">Nervus intermedius neuralgia</span><p id="par0180" class="elsevierStylePara elsevierViewall">Neuralgia caused by alterations affecting the seventh cranial nerve and characterised by attacks of acute pain deep in the ear canal.<a class="elsevierStyleCrossRef" href="#bib0175"><span class="elsevierStyleSup">1</span></a> Typical triggers include tragal pressure, cold, noise, and chewing.<a class="elsevierStyleCrossRef" href="#bib0175"><span class="elsevierStyleSup">1</span></a></p></span><span id="sec0110" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0160">Glossopharyngeal neuralgia</span><p id="par0185" class="elsevierStylePara elsevierViewall">Glossopharyngeal neuralgia is caused by irritation of the ninth cranial nerve, in the majority of cases due to a kink in the ipsilateral PICA.<a class="elsevierStyleCrossRef" href="#bib0175"><span class="elsevierStyleSup">1</span></a> Patients experience pain in the periauricular region and/or the posterior third of the tongue, the pharynx, and the tonsillar region.<a class="elsevierStyleCrossRef" href="#bib0175"><span class="elsevierStyleSup">1</span></a> Typical triggers are coughing, swallowing, sneezing, or yawning. In addition to paroxysms of typically lancinating pain, a burning or dull pain may be experienced between attacks.<a class="elsevierStyleCrossRef" href="#bib0175"><span class="elsevierStyleSup">1</span></a> Secondary causes include demyelinating lesions, local tumours, tonsillar abscesses, Chiari malformations and vascular aneurysms. It is important for differential diagnosis to consider Eagle syndrome; this syndrome features pharyngeal pain, which may be paroxysmal and triggered by swallowing, and may be reproduced with pressure on the ipsilateral tonsillar fossa. This syndrome is caused by calcification of the stylohyoid ligament.<a class="elsevierStyleCrossRef" href="#bib0340"><span class="elsevierStyleSup">34</span></a></p></span><span id="sec0115" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0165">Superior laryngeal neuralgia</span><p id="par0190" class="elsevierStylePara elsevierViewall">This neuralgia affects the tenth cranial nerve. It is characterised by attacks of lancinating pain in the anterolateral region of the neck, triggered by swallowing, turning of the neck, shouting, or singing.<a class="elsevierStyleCrossRef" href="#bib0175"><span class="elsevierStyleSup">1</span></a></p></span><span id="sec0120" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0170">Occipital neuralgias</span><p id="par0195" class="elsevierStylePara elsevierViewall">Occipital neuralgias are characterised by continuous or paroxysmal pain in the occipital region, often radiating to the upper parietal or even the frontal region. Typically, there is local sensitivity which reproduces the pain. These neuralgias are often associated with pathologies affecting the neck. They most commonly affect the greater occipital nerve, although cases have also been described in the lesser occipital and third occipital nerves.</p></span></span></span><span id="sec0125" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0175">Conclusions</span><p id="par0200" class="elsevierStylePara elsevierViewall">Better understanding of complementary tests, of criteria for referral to emergency departments and for admission, of which specialists should evaluate patients, and of how referral should be sought, will enable better treatment of patients with headache, both from PC physicians and emergency departments. However, this demonstrates many of the shortfalls seen in a great majority of centres at the national level, which lack headache units or the sufficient specialist clinics to guarantee that patients be managed with the necessary level of priority and that the proper tests are requested. Referring to official recommendations in order to optimise these issues will help to improve quality of life for patients with such a debilitating condition as headache, which on occasions also conceals less benign processes.</p></span><span id="sec0130" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0180">Conflicts of interest</span><p id="par0205" class="elsevierStylePara elsevierViewall">The authors have no conflicts of interest to declare.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:9 [ 0 => array:3 [ "identificador" => "xres1335533" "titulo" => "Abstract" "secciones" => array:3 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Introduction" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Development" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Conclusions" ] ] ] 1 => array:2 [ "identificador" => "xpalclavsec1230062" "titulo" => "Keywords" ] 2 => array:3 [ "identificador" => "xres1335532" "titulo" => "Resumen" "secciones" => array:3 [ 0 => array:2 [ "identificador" => "abst0020" "titulo" => "Introducción" ] 1 => array:2 [ "identificador" => "abst0025" "titulo" => "Desarrollo" ] 2 => array:2 [ "identificador" => "abst0030" "titulo" => "Conclusiones" ] ] ] 3 => array:2 [ "identificador" => "xpalclavsec1230061" "titulo" => "Palabras clave" ] 4 => array:2 [ "identificador" => "sec0005" "titulo" => "Introduction" ] 5 => array:3 [ "identificador" => "sec0010" "titulo" => "Recommendations" "secciones" => array:5 [ 0 => array:3 [ "identificador" => "sec0015" "titulo" => "Migraine with and without aura" "secciones" => array:2 [ 0 => array:2 [ "identificador" => "sec0020" "titulo" => "Episodic migraine" ] 1 => array:2 [ "identificador" => "sec0025" "titulo" => "Chronic migraine" ] ] ] 1 => array:3 [ "identificador" => "sec0030" "titulo" => "Tension-type headache" "secciones" => array:2 [ 0 => array:2 [ "identificador" => "sec0035" "titulo" => "Episodic tension-type headache" ] 1 => array:2 [ "identificador" => "sec0040" "titulo" => "Chronic tension-type headache" ] ] ] 2 => array:2 [ "identificador" => "sec0045" "titulo" => "Trigeminal autonomic cephalalgias" ] 3 => array:3 [ "identificador" => "sec0050" "titulo" => "Other primary headaches" "secciones" => array:8 [ 0 => array:2 [ "identificador" => "sec0055" "titulo" => "Primary cough headache" ] 1 => array:2 [ "identificador" => "sec0060" "titulo" => "Primary exercise headache" ] 2 => array:2 [ "identificador" => "sec0065" "titulo" => "Primary headache associated with sexual activity" ] 3 => array:2 [ "identificador" => "sec0070" "titulo" => "Primary thunderclap headache" ] 4 => array:2 [ "identificador" => "sec0075" "titulo" => "Primary stabbing headache" ] 5 => array:2 [ "identificador" => "sec0080" "titulo" => "Nummular headache" ] 6 => array:2 [ "identificador" => "sec0085" "titulo" => "Hypnic headache" ] 7 => array:2 [ "identificador" => "sec0090" "titulo" => "New persistent daily headache" ] ] ] 4 => array:3 [ "identificador" => "sec0095" "titulo" => "Craniofacial neuralgias" "secciones" => array:5 [ 0 => array:2 [ "identificador" => "sec0100" "titulo" => "Trigeminal neuralgia" ] 1 => array:2 [ "identificador" => "sec0105" "titulo" => "Nervus intermedius neuralgia" ] 2 => array:2 [ "identificador" => "sec0110" "titulo" => "Glossopharyngeal neuralgia" ] 3 => array:2 [ "identificador" => "sec0115" "titulo" => "Superior laryngeal neuralgia" ] 4 => array:2 [ "identificador" => "sec0120" "titulo" => "Occipital neuralgias" ] ] ] ] ] 6 => array:2 [ "identificador" => "sec0125" "titulo" => "Conclusions" ] 7 => array:2 [ "identificador" => "sec0130" "titulo" => "Conflicts of interest" ] 8 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2017-07-24" "fechaAceptado" => "2017-08-01" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec1230062" "palabras" => array:6 [ 0 => "Headache" 1 => "Neuralgia" 2 => "Primary care" 3 => "Emergency department" 4 => "Complementary test" 5 => "Patient referral" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec1230061" "palabras" => array:6 [ 0 => "Cefalea" 1 => "Neuralgia" 2 => "Atención primaria" 3 => "Urgencias" 4 => "Pruebas complementarias" 5 => "Derivación" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:3 [ "titulo" => "Abstract" "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Introduction</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">When a patient is diagnosed with primary headache or craniofacial neuralgia in the emergency department or in primary care, and is referred to a neurologist due to the complexity of the case, it is useful to know whether additional examination should be sought and the priority (urgent, preferential, or normal) with which the patient should be seen. This will avoid unnecessary delays in patients with disabling headache and where organic causes are suspected.</p><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">In order to issue recommendations on this matter, the Spanish Society of Neurology's Headache Study Group has decided to create a series of agreed recommendations constituting a referral protocol for patients with headache and/or craniofacial neuralgia.</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Development</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Young neurologists with an interest and experience in headache were invited to draft a series of practical guidelines in collaboration with the Spanish Society of Neurology's Headache Study Group Executive Committee. For practical reasons, the document was divided into 2 articles: this first article focuses on primary headaches and craniofacial neuralgias and the second on secondary headaches. In order for the recommendations to be helpful for daily practice they follow a practical approach, with tables summarising referral criteria, examinations to be performed, and referral to other specialists.</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Conclusions</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">We hope to offer a guide and tools to improve decision-making regarding patients with headache, identifying complementary tests to prioritise and referral pathways to be followed, in order to avoid duplicated consultations and delayed diagnosis and treatment.</p></span>" "secciones" => array:3 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Introduction" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Development" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Conclusions" ] ] ] "es" => array:3 [ "titulo" => "Resumen" "resumen" => "<span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Introducción</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Cuando tras una correcta anamnesis y exploración neurológica se diagnostica a un paciente con una cefalea primaria o una neuralgia craneofacial en urgencias o atención primaria y se decide derivar a neurología por complejidad es útil conocer si además se deberían solicitar exploraciones complementarias y la preferencia (urgente, preferente o normal) con la que se debería derivar para que el paciente llegue a la consulta del neurólogo sin demoras innecesarias en pacientes con dolores incapacitantes o con sospecha de organicidad.</p><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Por este motivo, el Grupo de Estudio de Cefalea de la Sociedad Española de Neurología, ha decidido crear unas recomendaciones consensuadas que establezcan un protocolo de derivación de pacientes con cefalea y/o neuralgias craneofaciales.</p></span> <span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Desarrollo</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Se ha contactado con neurólogos jóvenes con interés y experiencia en cefalea y con la Junta Directiva del Grupo de Estudio de Cefalea de la Sociedad Española de Neurología que han desarrollado este documento que, por razones prácticas, se ha dividido en 2 artículos. Esta primera centrada en las cefaleas o neuralgias craneofaciales primarias y una segunda que se focaliza en las cefaleas secundarias. El enfoque es práctico con tablas que resumen los criterios de derivación con exploraciones complementarias y otros especialistas a los que derivar, para que sea útil y facilite su uso en nuestra práctica asistencial diaria.</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Conclusiones</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Esperamos ofrecer una guía y herramientas para mejorar la toma de decisiones ante un paciente con cefalea, valorando exploraciones a priorizar y qué circuitos seguir para así evitar la duplicación de consultas y retrasos en el diagnóstico y en el tratamiento.</p></span>" "secciones" => array:3 [ 0 => array:2 [ "identificador" => "abst0020" "titulo" => "Introducción" ] 1 => array:2 [ "identificador" => "abst0025" "titulo" => "Desarrollo" ] 2 => array:2 [ "identificador" => "abst0030" "titulo" => "Conclusiones" ] ] ] ] "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0060">Please cite this article as: Gago-Veiga AB, García-Azorín D, Mas-Sala N, Ordás CM, Ruiz-Piñero M, Torres-Ferrús M, et al. Cómo y cuándo derivar un paciente con cefalea primaria y neuralgia craneofacial desde Urgencias y Atención Primaria: recomendaciones del Grupo de Estudio de Cefalea de la Sociedad Española de Neurología. Neurología. 2020;35:176–184.</p>" ] ] "multimedia" => array:8 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1929 "Ancho" => 2215 "Tamanyo" => 272507 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Alarm signs and symptoms (“red flags”) to be considered in patients with headache.</p>" ] ] 1 => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 1372 "Ancho" => 1667 "Tamanyo" => 153934 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Differentiating characteristics of the various trigeminal autonomic cephalalgias.</p>" ] ] 2 => array:8 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at1" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:3 [ "leyenda" => "<p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">CT, computed tomography; ECG, electrocardiogram; ESR, erythrocyte sedimentation rate; MRI, magnetic resonance imaging; PC, primary care; SAHS, sleep apnoea-hypopnoea syndrome; TMJ: temporomandibular joint; TSH, thyroid stimulating hormone.</p>" "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " colspan="2" align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Migraine</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " rowspan="4" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Complementary tests</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">From emergency department to neurology \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Urgent cranial CT scan<span class="elsevierStyleHsp" style=""></span>+<span class="elsevierStyleHsp" style=""></span>deferred brain MRI if <span class="elsevierStyleItalic">first episode of aura/atypical aura/refractory status migrainosus/red flags</span>Neurosonology and/or CT-angiography<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a><span class="elsevierStyleHsp" style=""></span>+<span class="elsevierStyleHsp" style=""></span>echocardiogram/Holter-ECG<a class="elsevierStyleCrossRefs" href="#tblfn0005"><span class="elsevierStyleSup">a,b</span></a> if <span class="elsevierStyleItalic">first episode of atypical aura without headache</span>Lumbar puncture if <span class="elsevierStyleItalic">atypical aura with/without fever and normal neuroimaging findings</span> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">From PC to neurology \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Polysomnography if <span class="elsevierStyleItalic">SAHS is suspected</span>ESR, TSHHypercoagulability study if <span class="elsevierStyleItalic">atypical and/or prolonged aura</span> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Referral to emergency department and/or admission \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Atypical or prolonged auraRefractory status migrainosusSecondary cause is suspectedPainkiller cessation following past failure in outpatient care \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Referral for outpatient follow-up \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">Primary care</span>: low-frequency episodic migraine/evaluation of possible risk factors for transformation to chronic migraine<span class="elsevierStyleItalic">Neurology (normal priority)</span>: high-frequency episodic migraine/prolonged attacks/habitual drugs contraindicated<span class="elsevierStyleItalic">Neurology (high priority)/headache unit</span>: chronic migraine/frequent and/or atypical auras \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Referral to other specialists \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">Ophthalmology</span> if atypical visual symptoms<span class="elsevierStyleItalic">Psychiatry</span> if co-presence of significant depression or anxiety disorder<span class="elsevierStyleItalic">Rehabilitation</span> if cervical pain or TMJ dysfunction<span class="elsevierStyleItalic">Maxillofacial surgery</span> if severe TMJ dysfunction<span class="elsevierStyleItalic">Endocrinology</span> if hormonal alteration and/or obesity<span class="elsevierStyleItalic">Pneumology</span> if SAHS is suspected \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab2289778.png" ] ] ] "notaPie" => array:2 [ 0 => array:3 [ "identificador" => "tblfn0005" "etiqueta" => "a" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">To be carried out in the emergency department or the outpatient clinic, depending on availability at the centre.</p>" ] 1 => array:3 [ "identificador" => "tblfn0010" "etiqueta" => "b" "nota" => "<p class="elsevierStyleNotepara" id="npar0010">Depending on clinical presentation, particularly vascular risk factors.</p>" ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Protocol for action and referral from emergency departments and PC for migraine and aura without headache.</p>" ] ] 3 => array:8 [ "identificador" => "tbl0010" "etiqueta" => "Table 2" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at2" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:1 [ "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Visual alarm symptom \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Opthalmic/neurological pathology to be ruled out \t\t\t\t\t\t\n \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Painful red eye and reduced visual acuity \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Opthalmic disorders: glaucoma, uveitis \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Progressive reduction in visual acuity and/or temporary darkening of vision \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Papilloedema \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Proptosis/exophthalmos \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Orbital space-occupying lesions/intracranial vascular problems/arteriovenous fistulas \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Oculomotor palsy \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Space-occupying/infiltrative/vascular/inflammatory lesions; Tolosa–Hunt syndrome \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Palpebral oedema, palpebral erythema and/or tumefaction (with fever or general discomfort) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Orbital cellulitis/orbital or retroorbital pathology \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Decreased visual acuity associated with headache and systemic symptoms in patients aged >50 years \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Temporal arteritis \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab2289777.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">Patient with headache and visual alarm symptoms and associated ophthalmic/neurological pathologies to be ruled out.</p>" ] ] 4 => array:8 [ "identificador" => "tbl0015" "etiqueta" => "Table 3" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at3" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:3 [ "leyenda" => "<p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">CT, computed tomography; ESR, erythrocyte sedimentation rate; SAHS, sleep apnoea and hypopnoea syndrome; TMJ, temporomandibular joint; TSH, thyroid stimulating hormone.</p>" "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " colspan="2" align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Tension-type headache</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " rowspan="4" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Complementary tests</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">From emergency department to neurology \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Cranial CT scan if <span class="elsevierStyleItalic">red flags</span>ESR in elderly patients \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">From PC to neurology \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Polysomnography if <span class="elsevierStyleItalic">SAHS is suspected</span>ESR, TSH<a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">a</span></a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Referral to emergency department and/or admission \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Secondary cause is suspected \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Referral for outpatient follow-up \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">Primary care</span><span class="elsevierStyleItalic">Neurology (normal priority)</span>: chronic tension-type headache and co-presence of painkiller abuse and/or failed prevention \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Referral to other specialists \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">Psychiatry</span> if co-presence of significant depression or anxiety disorder<span class="elsevierStyleItalic">Rehabilitation</span> if cervical pain or TMJ dysfunction<span class="elsevierStyleItalic">Maxillofacial surgery</span> if severe TMJ dysfunction<span class="elsevierStyleItalic">Pneumology</span> if SAHS is suspected \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab2289776.png" ] ] ] "notaPie" => array:1 [ 0 => array:3 [ "identificador" => "tblfn0015" "etiqueta" => "a" "nota" => "<p class="elsevierStyleNotepara" id="npar0015">In patients with chronic tension-type headache.</p>" ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">Protocol for action and referral from emergency departments and PC for tension-type headache.</p>" ] ] 5 => array:8 [ "identificador" => "tbl0020" "etiqueta" => "Table 4" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at4" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:1 [ "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " colspan="2" align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Trigeminal autonomic cephalalgias</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Complementary tests \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Urgent brain CT scan if <span class="elsevierStyleItalic">red flags</span>; evaluation of CT-angiography if <span class="elsevierStyleItalic">dissection is suspected</span>Deferred brain MRI, always using FIESTA sequences and MRI-angiography for SUNCT \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Referral to emergency department \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Disabling headacheSecondary cause is suspected \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Referral for outpatient follow-up \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">Headache unit</span> or <span class="elsevierStyleItalic">neurology department (high priority)</span> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Referral to other specialists \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">Psychiatry</span> if co-presence of significant depression or anxiety disorder/borderline personality disorder \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab2289779.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0080" class="elsevierStyleSimplePara elsevierViewall">Protocol for action and referral from emergency departments and PC for trigeminal autonomic cephalalgias.</p>" ] ] 6 => array:8 [ "identificador" => "tbl0025" "etiqueta" => "Table 5" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at5" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:3 [ "leyenda" => "<p id="spar0090" class="elsevierStyleSimplePara elsevierViewall">BP, blood pressure; CSF, cerebrospinal fluid; CT, computed tomography; ESR, erythrocyte sedimentation rate; IM, internal medicine; MRI, magnetic resonance imaging; NPH, nephrology; NS, neurosurgery; PNM, pneumology; SAT, supra-aortic trunks; TSH, thyroid stimulating hormone.</p>" "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Type of headache \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Complementary tests \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Referral for outpatient follow-up \t\t\t\t\t\t\n \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Cough headache \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Urgent brain CT scan if <span class="elsevierStyleItalic">first episode or red flags. Rule out posterior fossa lesions</span>Deferred brain MRI<a class="elsevierStyleCrossRef" href="#tblfn0020"><span class="elsevierStyleSup">a</span></a><span class="elsevierStyleHsp" style=""></span>→<span class="elsevierStyleHsp" style=""></span>A dynamic MRI CSF study and/or gandolinium-enhanced MRI may be considered if <span class="elsevierStyleItalic">tonsillar descent</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">Emergency department</span> if first episode and secondary cause is suspected \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Exercise headache \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Urgent brain CT scan/CT angiography if <span class="elsevierStyleItalic">first episode or red flags. Rule out SAH</span>Brain MRI and MRI-angiography for recurrent forms<a class="elsevierStyleCrossRef" href="#tblfn0025"><span class="elsevierStyleSup">b</span></a>Myocardial markers, catecholamines<a class="elsevierStyleCrossRef" href="#tblfn0030"><span class="elsevierStyleSup">c</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">Neurology (high priority)/headache unit</span> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Sexual headaches \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Urgent brain CT scan/CT angiography. <span class="elsevierStyleItalic">Rule out SAH</span>Brain MRI/MRI-angiography if <span class="elsevierStyleItalic">red flags</span>Lumbar puncture/ESR/D-dimer<a class="elsevierStyleCrossRef" href="#tblfn0030"><span class="elsevierStyleSup">c</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">IM</span>/<span class="elsevierStyleItalic">NPH</span>/<span class="elsevierStyleItalic">surgery</span>/<span class="elsevierStyleItalic">NS</span><a class="elsevierStyleCrossRef" href="#tblfn0040"><span class="elsevierStyleSup">e</span></a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Thunderclap headache \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Urgent brain CT scan/CT angiography. <span class="elsevierStyleItalic">Rule out SAH</span>Brain MRI/MRI-angiography including SAT if <span class="elsevierStyleItalic">red flags</span>Lumbar puncture/ESR/D-dimer<a class="elsevierStyleCrossRef" href="#tblfn0035"><span class="elsevierStyleSup">d</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="3" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Primary stabbing headache \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Brain CT scan if <span class="elsevierStyleItalic">recurring symptoms or red flags</span>Deferred MRI/MRI-angiography<a class="elsevierStyleCrossRef" href="#tblfn0030"><span class="elsevierStyleSup">c</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">Neurology (normal priority)</span> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Nummular headache \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Brain CT scan if <span class="elsevierStyleItalic">recurring symptoms or red flags</span>Deferred brain MRI<a class="elsevierStyleCrossRefs" href="#tblfn0030"><span class="elsevierStyleSup">c,d</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">Neurology (high priority)/headache unit</span> if pain is refractory \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Hypnic headache \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Brain CT scan if <span class="elsevierStyleItalic">recurring symptoms or red flags</span>Deferred brain MRI<a class="elsevierStyleCrossRef" href="#tblfn0030"><span class="elsevierStyleSup">c</span></a>ESR, TSH<a class="elsevierStyleCrossRef" href="#tblfn0030"><span class="elsevierStyleSup">c</span></a>Outpatient blood pressure monitoring<a class="elsevierStyleCrossRef" href="#tblfn0030"><span class="elsevierStyleSup">c</span></a>Polysomnography if <span class="elsevierStyleItalic">other SAHS symptoms are present</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">IM</span>/<span class="elsevierStyleItalic">PNM</span>/<span class="elsevierStyleItalic">NPH</span>/<span class="elsevierStyleItalic">NS</span><a class="elsevierStyleCrossRef" href="#tblfn0040"><span class="elsevierStyleSup">e</span></a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">New daily headache \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Brain CT scan if <span class="elsevierStyleItalic">recurring symptoms or CT-angiography revealing red flags</span><a class="elsevierStyleCrossRef" href="#tblfn0030"><span class="elsevierStyleSup">c</span></a>Deferred brain MRI<a class="elsevierStyleCrossRef" href="#tblfn0030"><span class="elsevierStyleSup">c</span></a>BP recordESR, TSH<a class="elsevierStyleCrossRef" href="#tblfn0030"><span class="elsevierStyleSup">c</span></a>Neck X-ray<a class="elsevierStyleCrossRef" href="#tblfn0030"><span class="elsevierStyleSup">c</span></a>Lumbar puncture to assess alterations to CSF dynamics \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab2289781.png" ] ] ] "notaPie" => array:5 [ 0 => array:3 [ "identificador" => "tblfn0020" "etiqueta" => "a" "nota" => "<p class="elsevierStyleNotepara" id="npar0020">With particular attention to the posterior fossa.</p>" ] 1 => array:3 [ "identificador" => "tblfn0025" "etiqueta" => "b" "nota" => "<p class="elsevierStyleNotepara" id="npar0025">It is essential to rule out space-occupying lesions or vascular malformations.</p>" ] 2 => array:3 [ "identificador" => "tblfn0030" "etiqueta" => "c" "nota" => "<p class="elsevierStyleNotepara" id="npar0030">In patients selected according to diagnostic suspicion.</p>" ] 3 => array:3 [ "identificador" => "tblfn0035" "etiqueta" => "d" "nota" => "<p class="elsevierStyleNotepara" id="npar0035">With particular attention to cerebral vault and extra-axial region.</p>" ] 4 => array:3 [ "identificador" => "tblfn0040" "etiqueta" => "e" "nota" => "<p class="elsevierStyleNotepara" id="npar0040">According to findings of complementary tests.</p>" ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0085" class="elsevierStyleSimplePara elsevierViewall">Protocol for action and referral from emergency departments and PC for other primary headaches.</p>" ] ] 7 => array:8 [ "identificador" => "tbl0030" "etiqueta" => "Table 6" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at6" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:3 [ "leyenda" => "<p id="spar0100" class="elsevierStyleSimplePara elsevierViewall">CT, computed tomography; IAC, internal auditory canal; MRI, magnetic resonance imaging; ORL, otorhinolaryngology.</p>" "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " colspan="2" align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Craniofacial neuralgias</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Complementary tests \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Brain MRI (always)<a class="elsevierStyleCrossRef" href="#tblfn0045"><span class="elsevierStyleSup">a</span></a>Angiography and 3-D imaging for trigeminal and glossopharyngeal neuralgiaFacial CT scan<a class="elsevierStyleCrossRef" href="#tblfn0050"><span class="elsevierStyleSup">b</span></a>Neck CT scan/MRI for superior and occipital laryngeal neuralgia if <span class="elsevierStyleItalic">Eagle syndrome is suspected</span> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Referral to emergency department \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">If incapacitating pain \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Referral for outpatient follow-up \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">Neurology (high priority)/headache unit</span> if pain is refractory \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Referral to other specialists \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">Maxillofacial surgery, ORL, neurosurgery</span><a class="elsevierStyleCrossRef" href="#tblfn0055"><span class="elsevierStyleSup">c</span></a> \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab2289780.png" ] ] ] "notaPie" => array:3 [ 0 => array:3 [ "identificador" => "tblfn0045" "etiqueta" => "a" "nota" => "<p class="elsevierStyleNotepara" id="npar0045">Focusing on posterior fossa and IAC in nervus intermedius neuralgia.</p>" ] 1 => array:3 [ "identificador" => "tblfn0050" "etiqueta" => "b" "nota" => "<p class="elsevierStyleNotepara" id="npar0050">In selected cases of neuralgia of terminal branches of the trigeminal nerve.</p>" ] 2 => array:3 [ "identificador" => "tblfn0055" "etiqueta" => "c" "nota" => "<p class="elsevierStyleNotepara" id="npar0055">Depending on type of neuralgia and findings. In glossopharyngeal/laryngeal/nervus intermedius neuralgias, ORL assessment is essential.</p>" ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0095" class="elsevierStyleSimplePara elsevierViewall">Protocol for action and referral from emergency departments and PC for the main craniofacial neuralgias.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:34 [ 0 => array:3 [ "identificador" => "bib0175" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Guía oficial para el diagnóstico y tratamiento de las cefaleas 2015" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "D. Ezpeleta" 1 => "P. Pozo-Rosich" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Libro" => array:3 [ "fecha" => "2015" "editorial" => "Editorial Luzán 5" "editorialLocalizacion" => "Madrid" ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0180" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:1 [ "autores" => array:1 [ 0 => array:2 [ "colaboracion" => "Headache Classification Committee of the International Headache Society (IHS)" "etal" => false ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Libro" => array:5 [ "edicion" => "3rd ed. beta version" "fecha" => "2013" "paginaInicial" => "629" "paginaFinal" => "808" "editorial" => "Cephalalgia" ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0185" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:1 [ "referenciaCompleta" => "Grupo de Estudio de Cefaleas de la Sociedad Española de Neurología. Guía práctica diagnóstico terapéutica de la Cefalea del adulto y el niño en urgencias." ] ] ] 3 => array:3 [ "identificador" => "bib0190" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Migraña otras cefaleas" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "V. Mateos-Marcos" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Libro" => array:5 [ "fecha" => "2011" "paginaInicial" => "31" "paginaFinal" => "60" "editorial" => "Elsevier" "editorialLocalizacion" => "Barcelona" ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0195" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Late-life migraine accompaniments: further experience" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "C.M. Fisher" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1161/01.str.17.5.1033" "Revista" => array:6 [ "tituloSerie" => "Stroke" "fecha" => "1986" "volumen" => "17" "paginaInicial" => "1033" "paginaFinal" => "1042" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/3532432" "web" => "Medline" ] ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0200" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Ischemic stroke subtypes and migraine with visual aura in the ARIC study" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "X.M. Androulakis" 1 => "N. Kodumuri" 2 => "L.D. Giamberardino" 3 => "W.D. Rosamond" 4 => "R.F. Gottesman" 5 => "E. Yim" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1212/WNL.0000000000003428" "Revista" => array:6 [ "tituloSerie" => "Neurology" "fecha" => "2016" "volumen" => "87" "paginaInicial" => "2527" "paginaFinal" => "2532" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27956563" "web" => "Medline" ] ] ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0205" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Diagnosis and clinical features of trigemino-autonomic headaches" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "A. May" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/head.12213" "Revista" => array:6 [ "tituloSerie" => "Headache" "fecha" => "2013" "volumen" => "53" "paginaInicial" => "1470" "paginaFinal" => "1478" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24090530" "web" => "Medline" ] ] ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0210" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "EFNS guidelines on the treatment of cluster headache and other trigeminal-autonomic cephalalgias" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "A. May" 1 => "M. Leone" 2 => "J.A. Frac" 3 => "M. Linded" 4 => "P.S. Sandore" 5 => "S. Eversf" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/j.1468-1331.2006.01566.x" "Revista" => array:6 [ "tituloSerie" => "Eur J Neurol" "fecha" => "2006" "volumen" => "13" "paginaInicial" => "1066" "paginaFinal" => "1077" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16987158" "web" => "Medline" ] ] ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib0215" "etiqueta" => "9" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "SUNCT syndrome. Diagnosis and treatment" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "J.A. Pareja" 1 => "A.B. Caminero" 2 => "O. Sjaastad" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.2165/00023210-200216060-00002" "Revista" => array:6 [ "tituloSerie" => "CNS Drugs" "fecha" => "2002" "volumen" => "16" "paginaInicial" => "373" "paginaFinal" => "383" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12027784" "web" => "Medline" ] ] ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib0220" "etiqueta" => "10" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "SUNCT and SUNA: recognition and treatment" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "J.A. Pareja" 1 => "M. Alvarez" 2 => "T. Montojo" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s11940-012-0211-8" "Revista" => array:6 [ "tituloSerie" => "Curr Treat Options Neurol" "fecha" => "2013" "volumen" => "15" "paginaInicial" => "28" "paginaFinal" => "39" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23242780" "web" => "Medline" ] ] ] ] ] ] ] ] 10 => array:3 [ "identificador" => "bib0225" "etiqueta" => "11" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Shortlasting, unilateral, neuralgiform headache attacks with conjuntival injection, tearing, sweating and rhinorrhea" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "O. Sjaastad" 1 => "C. Saunte" 2 => "R. Salvesen" 3 => "T.A. Fredriksen" 4 => "A. Seim" 5 => "O.D. Røe" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1046/j.1468-2982.1989.0902147.x" "Revista" => array:6 [ "tituloSerie" => "Cephalalgia" "fecha" => "1989" "volumen" => "9" "paginaInicial" => "147" "paginaFinal" => "156" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/2743414" "web" => "Medline" ] ] ] ] ] ] ] ] 11 => array:3 [ "identificador" => "bib0230" "etiqueta" => "12" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Chronic paroxysmal hemicrania and hemicrania continua. Parenteral indomethacin: the ‘indotest’" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "F. Antonaci" 1 => "J.A. Pareja" 2 => "A.B. Caminero" 3 => "O. Sjaastad" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1046/j.1526-4610.1998.3802122.x" "Revista" => array:6 [ "tituloSerie" => "Headache" "fecha" => "1998" "volumen" => "38" "paginaInicial" => "122" "paginaFinal" => "128" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9529768" "web" => "Medline" ] ] ] ] ] ] ] ] 12 => array:3 [ "identificador" => "bib0235" "etiqueta" => "13" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "A new clinical headache entity “chronic paroxysmal hemicrania”" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "O. Sjaastad" 1 => "I. Dale" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/j.1600-0404.1976.tb04788.x" "Revista" => array:6 [ "tituloSerie" => "Acta Neurol Scand" "fecha" => "1976" "volumen" => "54" "paginaInicial" => "140" "paginaFinal" => "159" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/782140" "web" => "Medline" ] ] ] ] ] ] ] ] 13 => array:3 [ "identificador" => "bib0240" "etiqueta" => "14" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Pathophysiology of cluster headache: a trigeminal autonomic cephalgia" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "P.J. Goadsby" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/s1474-4422(02)00104-7" "Revista" => array:6 [ "tituloSerie" => "Lancet Neurol" "fecha" => "2002" "volumen" => "1" "paginaInicial" => "251" "paginaFinal" => "257" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12849458" "web" => "Medline" ] ] ] ] ] ] ] ] 14 => array:3 [ "identificador" => "bib0245" "etiqueta" => "15" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Hemicrania continua. Another headache absolutely responsive to indomethacin" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "O. Sjaastad" 1 => "E.L.H. Spierings" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1046/j.1468-2982.1984.0401065.x" "Revista" => array:6 [ "tituloSerie" => "Cephalalgia" "fecha" => "1984" "volumen" => "4" "paginaInicial" => "65" "paginaFinal" => "70" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/6713526" "web" => "Medline" ] ] ] ] ] ] ] ] 15 => array:3 [ "identificador" => "bib0250" "etiqueta" => "16" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Update on hemicrania continua" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "E. Cittadini" 1 => "P.J. Goadsby" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s11916-010-0156-0" "Revista" => array:6 [ "tituloSerie" => "Curr Pain Headache Rep" "fecha" => "2011" "volumen" => "15" "paginaInicial" => "51" "paginaFinal" => "56" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21080113" "web" => "Medline" ] ] ] ] ] ] ] ] 16 => array:3 [ "identificador" => "bib0255" "etiqueta" => "17" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Other primary headaches" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "J. Pascual" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:2 [ "tituloSerie" => "Neurol Clin" "fecha" => "2009" ] ] ] ] ] ] 17 => array:3 [ "identificador" => "bib0260" "etiqueta" => "18" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Clues in the differential diagnosis of primary vs. secondary cough, exercise, and sexual headaches" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "R. Alvarez" 1 => "C. Ramõn" 2 => "J. Pascual" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/head.12449" "Revista" => array:6 [ "tituloSerie" => "Headache" "fecha" => "2014" "volumen" => "54" "paginaInicial" => "1560" "paginaFinal" => "1562" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25298032" "web" => "Medline" ] ] ] ] ] ] ] ] 18 => array:3 [ "identificador" => "bib0265" "etiqueta" => "19" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "European headache federation consensus on technical investigation for primary headache disorders" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "D.D. Mitsikostas" 1 => "M. Ashina" 2 => "A. Craven" 3 => "H.C. Diener" 4 => "P.J. Goadsby" 5 => "M.D. Ferrari" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1186/s10194-016-0596-y" "Revista" => array:5 [ "tituloSerie" => "J Headache Pain" "fecha" => "2015" "volumen" => "17" "paginaInicial" => "5" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26857820" "web" => "Medline" ] ] ] ] ] ] ] ] 19 => array:3 [ "identificador" => "bib0270" "etiqueta" => "20" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Cardiac cephalgia: a treatable form of exertional headache" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "R.B. Lipton" 1 => "T. Lowenkopf" 2 => "Z.H. Bajwa" 3 => "R.S. Leckie" 4 => "S. Ribeiro" 5 => "L.C. Newman" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1212/wnl.49.3.813" "Revista" => array:6 [ "tituloSerie" => "Neurology" "fecha" => "1997" "volumen" => "49" "paginaInicial" => "813" "paginaFinal" => "816" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9305346" "web" => "Medline" ] ] ] ] ] ] ] ] 20 => array:3 [ "identificador" => "bib0275" "etiqueta" => "21" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Primary thunderclap headache" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "F.H.H. Linn" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Libro" => array:5 [ "edicion" => "1st ed." "fecha" => "2010" "paginaInicial" => "473" "paginaFinal" => "481" "editorial" => "Elsevier B.V." ] ] ] ] ] ] 21 => array:3 [ "identificador" => "bib0280" "etiqueta" => "22" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:1 [ "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "J. Pareja" 1 => "J. Ruiz" 2 => "C. de Isla" 3 => "H. Al-Sabbah" 4 => "J. Espejo" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Libro" => array:4 [ "fecha" => "1996" "paginaInicial" => "93" "paginaFinal" => "96" "editorial" => "Cephalalgia" ] ] ] ] ] ] 22 => array:3 [ "identificador" => "bib0285" "etiqueta" => "23" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Numular headache: a coin-shaped cephalgia" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "J.A. Pareja" 1 => "A.B. Caminero" 2 => "J. Serra" 3 => "F.J. Barriga" 4 => "M. Baron" 5 => "J.L. Dobato" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1212/wnl.58.11.1678" "Revista" => array:6 [ "tituloSerie" => "Neurology" "fecha" => "2002" "volumen" => "58" "paginaInicial" => "1678" "paginaFinal" => "1679" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12058099" "web" => "Medline" ] ] ] ] ] ] ] ] 23 => array:3 [ "identificador" => "bib0290" "etiqueta" => "24" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Nummular headache update" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "J.A. Pareja" 1 => "T. Montojo" 2 => "M. Alvarez" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s11910-011-0247-2" "Revista" => array:6 [ "tituloSerie" => "Curr Neurol Neurosci Rep" "fecha" => "2012" "volumen" => "12" "paginaInicial" => "118" "paginaFinal" => "124" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22203526" "web" => "Medline" ] ] ] ] ] ] ] ] 24 => array:3 [ "identificador" => "bib0295" "etiqueta" => "25" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Nummular headache update" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "D.P. Schwartz" 1 => "M.S. Robbins" 2 => "B.M. Grosberg" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s11916-013-0340-0" "Revista" => array:5 [ "tituloSerie" => "Curr Pain Headache Rep" "fecha" => "2013" "volumen" => "17" "paginaInicial" => "340" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23616207" "web" => "Medline" ] ] ] ] ] ] ] ] 25 => array:3 [ "identificador" => "bib0300" "etiqueta" => "26" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Hypnic headache" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "M. Lanteri-Minet" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Headache" "fecha" => "2014" "volumen" => "54" "paginaInicial" => "1556" "paginaFinal" => "1559" ] ] ] ] ] ] 26 => array:3 [ "identificador" => "bib0305" "etiqueta" => "27" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Hypnic headache: a review of clinical features, therapeutic options and outcomes" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "J.-F. Liang" 1 => "S.-J. Wang" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1177/0333102414537914" "Revista" => array:6 [ "tituloSerie" => "Cephalalgia" "fecha" => "2014" "volumen" => "34" "paginaInicial" => "795" "paginaFinal" => "805" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24942086" "web" => "Medline" ] ] ] ] ] ] ] ] 27 => array:3 [ "identificador" => "bib0310" "etiqueta" => "28" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Long-term outcomes and clinical characteristics of hypnic headache syndrome: 40 patients series from a tertiary referral center" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "N. Tariq" 1 => "E. Estemalik" 2 => "B. Vij" 3 => "J.S. Kriegler" 4 => "S.J. Tepper" 5 => "M.J. Stillman" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/head.12796" "Revista" => array:6 [ "tituloSerie" => "Headache" "fecha" => "2016" "volumen" => "56" "paginaInicial" => "717" "paginaFinal" => "724" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27015738" "web" => "Medline" ] ] ] ] ] ] ] ] 28 => array:3 [ "identificador" => "bib0315" "etiqueta" => "29" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "New daily persistent headache" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "R.W. Evans" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/j.1526-4610.2012.02135.x" "Revista" => array:7 [ "tituloSerie" => "Headache" "fecha" => "2012" "volumen" => "52" "numero" => "Suppl. 1" "paginaInicial" => "40" "paginaFinal" => "44" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22540206" "web" => "Medline" ] ] ] ] ] ] ] ] 29 => array:3 [ "identificador" => "bib0320" "etiqueta" => "30" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "New daily persistent headache" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "P.J. Goadsby" 1 => "C. Boes" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1136/jnnp.72.suppl_2.ii6" "Revista" => array:7 [ "tituloSerie" => "J Neurol Neurosurg Psychiatry" "fecha" => "2002" "volumen" => "72" "numero" => "Suppl. 2" "paginaInicial" => "ii6" "paginaFinal" => "ii9" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12122194" "web" => "Medline" ] ] ] ] ] ] ] ] 30 => array:3 [ "identificador" => "bib0325" "etiqueta" => "31" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Update on new daily persistent headache" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "H. Nierenburg" 1 => "L.C. Newman" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s11940-016-0408-3" "Revista" => array:5 [ "tituloSerie" => "Curr Treat Options Neurol" "fecha" => "2016" "volumen" => "18" "paginaInicial" => "25" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27080086" "web" => "Medline" ] ] ] ] ] ] ] ] 31 => array:3 [ "identificador" => "bib0330" "etiqueta" => "32" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:1 [ "titulo" => "Epidemiology of typical and atypical craniofacial neuralgias" ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Neurol Sci" "fecha" => "2005" "volumen" => "26" "numero" => "Suppl. 2" "paginaInicial" => "65" "paginaFinal" => "67" ] ] ] ] ] ] 32 => array:3 [ "identificador" => "bib0335" "etiqueta" => "33" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Numb cheek syndrome: a sign of infraorbital neuropathy" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "W.W. Campbell Jr." ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1212/wnl.36.3.421" "Revista" => array:6 [ "tituloSerie" => "Neurology" "fecha" => "1986" "volumen" => "36" "paginaInicial" => "421" "paginaFinal" => "423" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/3951714" "web" => "Medline" ] ] ] ] ] ] ] ] 33 => array:3 [ "identificador" => "bib0340" "etiqueta" => "34" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:1 [ "titulo" => "Eagle's syndrome: signs and symptoms" ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1179/crn.2013.008" "Revista" => array:6 [ "tituloSerie" => "Cranio" "fecha" => "2013" "volumen" => "31" "paginaInicial" => "56" "paginaFinal" => "60" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23461263" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/21735808/0000003500000003/v1_202005131017/S2173580817301347/v1_202005131017/en/main.assets" "Apartado" => array:4 [ "identificador" => "9408" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Review article" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/21735808/0000003500000003/v1_202005131017/S2173580817301347/v1_202005131017/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173580817301347?idApp=UINPBA00004N" ]
Year/Month | Html | Total | |
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2024 October | 26 | 9 | 35 |
2024 September | 75 | 19 | 94 |
2024 August | 72 | 17 | 89 |
2024 July | 51 | 11 | 62 |
2024 June | 64 | 19 | 83 |
2024 May | 48 | 7 | 55 |
2024 April | 58 | 9 | 67 |
2024 March | 98 | 9 | 107 |
2024 February | 98 | 10 | 108 |
2024 January | 72 | 4 | 76 |
2023 December | 78 | 16 | 94 |
2023 November | 89 | 8 | 97 |
2023 October | 121 | 11 | 132 |
2023 September | 52 | 6 | 58 |
2023 August | 46 | 7 | 53 |
2023 July | 71 | 9 | 80 |
2023 June | 60 | 5 | 65 |
2023 May | 76 | 15 | 91 |
2023 April | 60 | 3 | 63 |
2023 March | 66 | 7 | 73 |
2023 February | 66 | 10 | 76 |
2023 January | 58 | 7 | 65 |
2022 December | 50 | 16 | 66 |
2022 November | 49 | 19 | 68 |
2022 October | 57 | 12 | 69 |
2022 September | 43 | 20 | 63 |
2022 August | 59 | 15 | 74 |
2022 July | 37 | 15 | 52 |
2022 June | 44 | 11 | 55 |
2022 May | 40 | 20 | 60 |
2022 April | 70 | 14 | 84 |
2022 March | 78 | 15 | 93 |
2022 February | 52 | 8 | 60 |
2022 January | 88 | 7 | 95 |
2021 December | 62 | 19 | 81 |
2021 November | 47 | 10 | 57 |
2021 October | 67 | 26 | 93 |
2021 September | 45 | 17 | 62 |
2021 August | 46 | 11 | 57 |
2021 July | 32 | 21 | 53 |
2021 June | 25 | 11 | 36 |
2021 May | 42 | 16 | 58 |
2021 April | 111 | 12 | 123 |
2021 March | 63 | 10 | 73 |
2021 February | 34 | 11 | 45 |
2021 January | 41 | 18 | 59 |
2020 December | 48 | 13 | 61 |
2020 November | 47 | 15 | 62 |
2020 October | 48 | 11 | 59 |
2020 September | 37 | 17 | 54 |
2020 August | 52 | 12 | 64 |
2020 July | 23 | 11 | 34 |
2020 June | 34 | 20 | 54 |
2020 May | 25 | 20 | 45 |
2020 April | 14 | 10 | 24 |
2020 March | 31 | 16 | 47 |
2020 February | 19 | 8 | 27 |
2020 January | 20 | 9 | 29 |
2019 December | 25 | 11 | 36 |
2019 November | 9 | 5 | 14 |
2019 October | 13 | 4 | 17 |
2019 September | 10 | 24 | 34 |
2019 August | 11 | 9 | 20 |
2019 July | 20 | 13 | 33 |
2019 June | 43 | 27 | 70 |
2019 May | 110 | 34 | 144 |
2019 April | 61 | 20 | 81 |
2019 March | 8 | 7 | 15 |
2019 February | 21 | 8 | 29 |
2019 January | 17 | 3 | 20 |
2018 December | 10 | 6 | 16 |
2018 November | 31 | 5 | 36 |
2018 October | 42 | 9 | 51 |
2018 September | 21 | 11 | 32 |
2018 August | 0 | 8 | 8 |
2018 July | 0 | 6 | 6 |
2018 June | 0 | 4 | 4 |
2018 May | 3 | 1 | 4 |
2018 April | 0 | 1 | 1 |
2018 March | 6 | 2 | 8 |
2018 February | 0 | 4 | 4 |
2018 January | 1 | 5 | 6 |
2017 December | 2 | 6 | 8 |
2017 November | 2 | 7 | 9 |
2017 October | 3 | 9 | 12 |