A common primary headache disorder, characterized by a dull, non-pulsatile, diffuse, band-like (or vice-like) pain of mild to moderate intensity in the head, scalp or neck. The subtypes are classified by frequency and severity of symptoms. There is no clear cause even though it has been associated with muscle contraction and stress.<unk> s, which were renamed<unk> -type headaches by the International Headache Society in 1988, are the most common type of primary headaches. The pathophysiology for<unk>  type headache is multifactorial and generally includes increased sensitivity of central and peripheral nociceptive  pathways, environmental and genetic factors. It includes hypersensitivity of central and peripheral nociceptive  pathways: lack of habituation, Nitric oxide and combination of genetic and envirommental factors. The exact cause of<unk> -type headaches is still unknown. Multiple pathophysiologic mechanisms explain the possible etiologies or causative factors.  Differential diagnosis if<unk>  type headache includes; Migraine, Cluster headache, Secondary headaches such as Medication overuse, Sinus headache and Cervicogenic headache.<unk>  is one of the most common type of headaches.<unk> -type headache (TTH) is the most prevalent headache in the general population.<unk> -type headache (TTH) is the second-most prevalent disorder in the world. A Danish Registry showed 1 year prevalances of  infrequent episodic, frequent episodic and and chronic TTH were 63.5, 21.6 and 0.9% respectively.  Various precipitating factors may cause TTH in susceptible individuals. One half of patients with TTH identify stress or hunger as a precipitating factor; stress, sleep deprivation, irregular meal time (hunger), eyestrain. Diagnostic criteria for<unk> -type headache is specified by the International Classification of Headache Disorders, 3rd edition (ICHD-3).<unk> -type headache pain is often described as a constant pressure, as if the head were being squeezed in a vise. The pain is frequently bilateral which means it is present on both sides of the head at once.<unk> -type headache pain is typically mild to moderate, but may be severe. In contrast to migraine, the pain does not increase during exercise.<unk>  type headache may have following examination findings: Increased pericranial muscle (head, neck or shoulders) and myofascial tissue tenderness on manual palpation. Increased number of myofacial trigger points: frontal, temporal, masseter, ptrygoid, sternocleidomastoid, splenius, and trapezius mucles. Neuro-imaging is generally  not indicated for patients with TTH. Usually indicated if abnormal neurologic examination findings or atypical presentation or presentation not fulfilling the ICHD-3 criteria. Neuro-imaging with an magnetic resonance imaging (MRI) scan with and without contrast is preferred to non-contrast computed tomography (CT) scan. MRI is usually indicated to rule out underlying structural brain lesion or to evaluate brain and pituitary gland in patient presenting with typical features or highly suspicious of TTH. Episodic<unk> -type headaches generally respond well to over-the-counter analgesics, such as paracetamol, ibuprofen or aspirin.  Simple analgesic monotherapy such as NSAIDS or aspirin are recommended (Grade 1A) for episodic TTH treatment requiring patients. Simple analgesic monotherapy is used in combination with caffeine for TTH patients who are unresponsive or have a poor response to analgesic monotherapy (Grdae 2A). Combination therapies including opioids or butalbital are not recommended as first line agents for TTH Rx (Grade 1C). Inpatient treatment for severe TTH can be treated in addition to the above mentioned treatment with chlorpromazine, metoclopramide, combination of metoclopramide and diphenhydramine and intramuscular ketorolac.  TTH prevention and prophylactic treatment is generally indicated for chronic TTH and frequent episodic TTH. Data regarding pharmacologic prevention and prophylactic treatment is limited and not well established. Drugs that can be used are; TCA (amitriptyline), SSRI (mirtazapine, venlafaxine), and anticonvulsants (gabapentin, topiramate). Behavioral treatments include; relaxation, biofeedback, and CBT. For patients with frequent episodic or chronic TTH, combined Rx with TCA plus stress management therapy is recommended rather than alone therapy with TCA or behavioral therapy alone. (Grade 2B). For patients with frequent episodic or chronic TTH, having preference for pharmacologic therapy rather than behavioral therapy, TCA with amitriptyline is recommended. (Grade 2B). For patients with frequent episodic or chronic TTH, not needing pharmacologic therapy, electromyography biofeedback combined with relaxation therapy is recommended. (Grade 2B). For patients with frequent episodic or chronic TTH, who cannot tolerate or require more effective treatments such as amitriptyline and biofeedback, accupuncture (Grade 2B) or physical therapy (Grade 2C) is recommended.
Tension headache
Cluster headache
Thunderclap headache
Red wine headache
Rebound headache
Morning headache
Migraine
Benign positional vertigo 