Chronic Daily Headache

“Chronic daily headache” (CDH) is the term used when patient experiences a headache for 15 days or more in a month. Chronic daily headache is a very broad term and has many causes. Chronic daily headache is not a single entity and it covers a number of different headache syndromes, including chronic TTH (tension type headache) as well as headache secondary to inflammation, infection, medication overuse, trauma and many other causes.

Many studies suggest that about 4% of adult population have daily or near-daily headache (Chronic daily headache). Chronic daily headache may be primary or secondary (which is an important consideration in guiding management of this complaint). In secondary causes, treatment of actual underlying cause can relieve the patient from chronic daily headache.

Primary causes of chronic daily headache:

Headache lasting for more than 4 hours a day- chronic migraine, chronic tension-type headache (TTH), hemicrania continua, New daily persistent headache etc. (all of these may be complicated by medicine usually analgesic overuse).

Headache lasting for less than 4 hours a day- Chronic cluster headache (some patients with chronic cluster headache may have headache that last for more than 4 hours a day), chronic paroxysmal hemicrania, hypnic headache, SUNCT (short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing)/SUNA (short-lasting unilateral neuralgiform headache attacks with cranial autonomic symptoms).

Secondary causes of chronic daily headache:

Secondary causes of chronic daily headache are posttraumatic (due to head injury, post-infectious, iatrogenic), inflammatory (Giant cell arteritis, Behçet’s syndrome, Sarcoidosis), medication-overuse headache, chronic central nervous system (CNS) infection, etc.