Not All Severe Primary Headaches are Migraines - Tension Type Headaches are Far More Common Yet often Labelled as Migraines

Introduction: This paper reinforces the concept that headaches reside on a continuum with migraine type headache at one end of the spectrum and Tension Type Headache (TTHs) at the other with what used to be referred to as tension/vascular headaches, along that continuum. Background information: This brief overview of headaches is based upon almost half a century of clinical neurological experience by the author, rather than an in depth analysis of definitions and is also dependent upon impressions of patient responses to treatment. Results: Based upon clinical experience, one of the most common complaints that present to the neurologist is that of chronic headache, or headache in general, and so long as the headache is significantly intrusive it is referred to the consultant as a case of migraine even if the evidence favours an alternative headache type such as TTH. Discussion: This paper confirms the concept, demonstrated in previous studies, that there is a continuum spectrum of headache types, with patients moving along that continuum with changing presentations at various times during a long history of headaches.