ICHD-II Diagnostic Criteria for Headache Attributed to Non-Vascular Intracranial Disorder

A. Progressive headache with at least 1 of the following characteristics and fulfilling criteria C-D:

  1. Daily occurrence
  2. Diffuse and/or constant (non-pulsating) pain
  3. Aggravated by coughing or straining

B. Intracranial hypertension fulfilling the following criteria:

  1. Alert patient with neurological examination that either is normal or demonstrates any of the following abnormalities:
    1. Papilloedema
    2. Enlarged blind spot
    3. Visual field defect (progressive if untreated)
    4. Sixth nerve palsy
  2. Increased CSF pressure (>200 mm H2O in the nonobese, >250 mm H2O in the obese) measured by lumbar puncture in the recumbent position or by epidural or intraventricular pressure monitoring
  3. Normal CSF chemistry (low CSF protein is acceptable) and cellularity
  4. Intracranial diseases (including venous sinus thrombosis) ruled out by appropriate investigations
  5. No metabolic, toxic or hormonal cause of intracranial hypertension

C. Headache develops in close temporal relation to increased intracranial pressure

D. Headache improves after withdrawal of CSF to reduce pressure to 120-170 mm H2O and resolves within 72 hours of persistent normalisation of intracranial pressure

Headache attributed to increased intracranial pressure or hydrocephalus caused by neoplasm

A. Diffuse non-pulsating headache with at least 1 of the following characteristics and fulfilling criteria C-D:

  1. Associated with nausea and/or vomiting
  2. Worsened by physical activity and/or manoeuvres known to increase intracranial pressure (such as Valsalva manoeuvre, coughing or sneezing)
  3. Occurring in attack-like episodes

B. Space-occupying intracranial tumour* demonstrated by CT or MRI and causing hydrocephalus

C. Headache develops and/or deteriorates in close temporal relation to the hydrocephalus

D. Headache improves within 7 days after surgical removal or volume-reduction of tumour

*including colloid cyst of the IIIrd ventricle.

Headache attributed directly to neoplasm

A. Headache with at least 1 of the following characteristics and fulfilling criteria C-D:

  1. progressive
  2. localised
  3. orse in the morning
  4. aggravated by coughing or bending forward

B. Intracranial neoplasm shown by imaging

C. Headache develops in temporal (and usually spatial) relation to the neoplasm

D. Headache resolves within 7 days after surgical removal or volume-reduction of neoplasm or treatment with corticosteroids

 

 

References:

  1. International Headache Society. The International Classification of Headache Disorders, 2nd Edition. Cephalalgia 2004; 24 (suppl 1): 1-160 (www.i-h-s.org)

This material was taken from the International Classification of Headache Disorders. It is intended for educational purposes only.

Created: June 13, 2005