ABSTRACT
Age is an important factor in the diagnosis and treatment of headache disorders. Headache prevalence varies with age. The incidence of primary headache disorders declines dramatically while the incidence of secondary headache disorders increases with advancing age. In the International Headache Society criteria, mass lesions are included in the category called 'headache associated with nonvascular intracranial disorders'. Giant cell arteritis (GCA) should be considered in any elderly patient who has new-onset headaches or a substantial change in headache pattern. Stroke and transient ischemic attack can occur in GCA. The history and physical examination may support the diagnosis of GCA. One way of expressing the likelihood of GCA is a statistic termed the likelihood ratio. GCA is characterized pathologically by skip lesions; affected and unaffected segments may be adjacent. In the elderly, trigeminal neuralgia most often results from neurovascular compression of the trigeminal nerve owing to abnormal arterial loops near the trigeminal nerve root entry zone.
