ABSTRACT
Patients with secondary organic headache types often have symptoms that mimic tension-type headache (TTH). Pericranial tenderness can also be found in other primary headaches, as well as asymptomatic headaches, e.g. intracerebral lesions, such as tumour or haemorrhage and therefore, one must be alert for atypical symptoms or any abnormalities on neurologic examination. The prognosis and clinical course of TTH are variable. Patients with frequent episodic tension-type headache (ETTH) may be at increased risk of developing chronic tension-type headache (CTTH) over a period of many years. Some believe that CTTH can mask depression or other serious emotional disorders. The relationship between headache and depression is complicated. Patients with depression headache frequently suffer from chronic migraine. Nonpharmacologic treatment modalities should be considered in primary headache management. Patients should be taught healthy habits, such as obtaining adequate sleep, eating balanced meals, and getting regular exercise, and told to eliminate unhealthy habits, such as smoking and excess drinking.
