General
This is the most common primary headache disorder, affecting approximately 38% of the population.
What is tension-type headache?
Tension-type headaches are typically described as this type of pain quality.
What is bilateral pressing or tightening pain?
A definite migraine diagnosis requires at least this many headache attacks fulfilling ICHD-3 criteria.
What is 5?
Cluster headaches are classically described as severe, unilateral pain in this specific location, accompanied by ipsilateral autonomic features such as lacrimation, conjunctival injection, and nasal congestion.
What is periorbital/retro-orbital (behind or around the eye)
According to AAFP guidance, this is the preferred imaging modality for sudden severe headache concerning for subarachnoid hemorrhage in the acute setting.
What is noncontrast CT head?
This secondary headache disorder is defined by headache occurring on ≥15 days per month in a patient who has been overusing acute headache medications for more than 3 months.
What is medication overuse headache (MOH)?
A definite diagnosis of tension-type headache requires at least this many headache episodes in a patient's lifetime.
What is 10?
According to AAFP and American Headache Society guidance, these medications are considered first-line abortive therapy for mild-to-moderate migraine
AND
moderate-to-severe migraine attacks.
What are NSAIDs or acetaminophen?
What are triptans?
Unlike migraine patients who prefer to lie still, patients with cluster headache classically exhibit this behavior during an attack.
What is restlessness or agitation (pacing)?
According to the 2025 American Headache Society guideline update, this dopamine receptor antagonist at 10–12.5 mg IV received a Level A ("Must Offer") recommendation for acute migraine in the ED.
What is prochlorperazine (Compazine)?
This mnemonic, with 10 red flag categories, is used to systematically screen for secondary causes of headache.
What is SNNOOP10?
Chronic tension-type headache is defined as headache occurring on ≥15 days per month for more than this duration, and preventive therapy should be considered when attacks reach ≥10 per month or cause significant disability.
What is 3 months?
This newer class of oral migraine-specific acute treatments (e.g., ubrogepant, rimegepant) is considered nonvasoconstrictive, making it an option for patients who cannot take triptans.
What are gepants (CGRP receptor antagonists)?
The first-line acute treatment for cluster headache includes high-flow oxygen and this medication class.
What is triptans
Subcutaneous sumatriptan may be the most effective acute treatment.
This diagnosis should be considered in older adults presenting with new headache, jaw claudication, and elevated ESR/CRP. AAFP guidance recommends immediate initiation of this medication class even before biopsy confirmation.
What is giant cell arteritis (temporal arteritis) treated with high-dose glucocorticoids (prednisone 40–60 mg/day)?
According to the ICHD-3, the threshold for overuse of simple analgesics (e.g., acetaminophen, NSAIDs) is this many days per month, while the threshold for triptans, opioids, or combination analgesics is at 10 days per month.
What is 15 days per month?
This medication class is discouraged for routine tension-type headache treatment because of high medication overuse risk.
What are butalbital-containing medications or opioids?
These two medications are considered first-line for acute migraine treatment during pregnancy.
What is acetaminophen and metoclopramide.
This medication is the most commonly used preventive therapy for cluster headache.
What is verapamil?
This diagnosis should be suspected in a patient presenting with headache, papilledema, and pulsatile tinnitus, especially in obese women of childbearing age. This medication is considered first-line pharmacologic treatment.
What is idiopathic intracranial hypertension (pseudotumor cerebri) treated with acetazolamide?
This vasoactive neuropeptide, released by dural nociceptive axonal terminals, is a key mediator in migraine pathophysiology and the target of multiple new drug classes.
What is calcitonin gene-related peptide (CGRP)?
This medication is considered the first-line pharmacologic preventive therapy for chronic tension-type headache based on the strongest available evidence.
What is amitriptyline?
The American College of Physicians (ACP) recommends the following stepwise approach for episodic migraine prophylaxis in nonpregnant adults.
What is
1. Propranolol or metoprolol (beta-blockers)
2. Valproate (antiseizure medication)
3. Venlafaxine (SNRI)
4. Amitriptyline (tricyclic antidepressant)
This is the only CGRP monoclonal antibody that is FDA-approved specifically for the treatment of episodic cluster headache in adults.
What is galcanezumab (Emgality)?
What is the "migraine cocktail"
What is
NSAID (Ketorolac 30mg IV)
Dopamine Recep Ant. (Prochlorperazine 10mg IV/Metoclopramide)
Antihistamine (Diphenhydramine 25mg IV)
Steroid (Dexamethasone 10mg IV)
For hospitalized patients with intractable or refractory migraine, the American Society of Regional Anesthesia and Pain Medicine (ASRA) 2026 practice advisory expands the toolkit beyond the standard cocktail to include IV magnesium sulfate (1–2 g over 15 min), IV valproic acid, IV steroids (dexamethasone or methylprednisolone for 1–3 days), and in refractory cases, IV lidocaine or ketamine infusions