A Historical Review of Headaches: Who First Described Them and When did This Occur?

Wallyson Pablo de Oliveira Souza; Patrick Mesquita Sousa-Santos; Raimundo Pereira Silva-Néto, MD, MSc, PhD


Headache. 2020;60(8):1535-1541. 

In This Article

Primary Headaches


The first description of migraine is attributed to the famous Greek doctor Arataeus (120–180), in the 2nd century AD. He was born in Cappadocia, present-day Asian Turkey, and described a form of intermittent headache that affected half the head and called it heterocrania.[4,5] However, still in the 2nd century AD, Claudius Galenus (129–201) coined the term hemicrania ("hemi," half; and "crania," skull) to designate a type of headache that often affected only 1 side of the head. Later, before the Norman invasion, in the 11th century, the term hemicrania evolved in the French language to become the word migraine as it is known today.[5–7] In Brazil, since 1985, migraine is known by the term migrânea that was created by Edgard Raffaelli Júnior (1930–2006).[8,9]

Status Migrainosus

Status migrainosus is a severe complication of migraine characterized by disabling pain crises that last for longer than 72 hours, without remission, and unresponsive to usual treatments.[3] The term status migrainosus was first used by British neurologist Domino Taverner in 1978 to describe "severe and prolonged, or frequently repeated migraine."[10]

Cluster Headache

In 1641, cluster headache was first described by Dutch doctor Nicolaas Tulp (1593–1674),[11] but the first full description of this headache was given in 1745 by Austrian doctor Gerhard van Swieten (1700–1772) in his book Commentaria in Herrnanni Boer-haave Aphorismos de cognoscendis et curandis morbis.[12,13] The term "cluster headache" was coined by American neurologist E. Charles Kunkle in 1954, to highlight the typical form of pain recurrence.[14]

Paroxysmal Hemicrania

Paroxysmal hemicrania is characterized by the attacks of severe and strictly unilateral headache, which is orbital, supraorbital, temporal or in any combination of these sites, lasting 2–30 minutes and occurring several times a day. The attacks are usually associated with ipsilateral conjunctival injection, lacrimation, nasal congestion, rhinorrhea, forehead, and facial sweating, miosis, ptosis, and/or eyelid edema. They respond to indomethacin.[3] This headache was first described in 1976 by the Norwegian neurologists Ottar Sjaastad and Inge Dale.[15]

Short-lasting Unilateral Neuralgiform Headache Attacks With Conjunctival Injection and Tearing (SUNCT)

This headache is characterized by headache attacks, moderate or severe intensity, strictly unilateral, lasting seconds to minutes, occurring at least once a day, and usually associated with conjunctival injection and lacrimation.[3] SUNCT syndrome was first described in 1978 by Sjaastad et al[16] but its complete description was made only in 1989 by the same author.[17]

Hemicrania Continua

Hemicrania continua is a persistent, strictly unilateral, headache associated with ipsilateral conjunctival injection, lacrimation, nasal congestion, rhinorrhea, forehead and facial sweating, miosis, ptosis and/or eyelid edema, and/or with restlessness or agitation. The headache is sensitive to indomethacin.[3] Hemicrania continua was first described in 1983 by 2 neurologists, Ottar Sjaastad and Egilius Spierings.[18]

Primary Cough Headache

Primary cough headache is precipitated by coughing or other Valsalva (straining) maneuver, but not by prolonged physical exercise, in the absence of any intracranial disorder.[3] Initially, cough headache was considered as an alarming symptom. It was first described in the medical literature in 1932 by French doctor Jules Tinel (1879–1952),[19] but in 1956, Symonds and Rooke reported cases of benign cough headache, now known as primary cough headache.[20,21]

Primary Exercise Headache

Primary exercise headache is an entity, previously known as exertional headache, is a headache precipitated by any form of exercise in the absence of any intracranial disorder.[3] The term exertional headache was first used by Jules Tinel in 1932 to describe 4 patients with an intermittent paroxysmal headache that occurred only during effort.[22] In 1968, Rooke proposed the term "benign exertional headache" for any headache precipitated by "exertion," such as running, bending, coughing, sneezing, and heavy lifting or straining in the stool.[21]

Primary Headache Associated With Sexual Activity

This headache is precipitated by sexual activity, usually starting as a dull bilateral ache as sexual excitement increases and suddenly becoming intense at orgasm, in the absence of any intracranial disorder.[3] The first description of headache associated with sexual activity was made in the 2nd century by Avicenna (980–1037 AD), a doctor born in Bukhara, now Uzbekistan, in his book Canon of Medicine. In the first chapter of this book, Avicenna discusses sexual headache and calls it "Sodda-e-Jemaee" which literally means: "headache associated with sexual intercourse."[23]

Primary Thunderclap Headache

Thunderclap headache was first described in 1986 by 2 neurologists, 1 English, James W. Day and the other American, Neil H. Raskin to describe the symptoms of a patient with an unruptured aneurysm.[24] It is a high-intensity headache of abrupt onset, mimicking that of ruptured cerebral aneurysm, in the absence of any intracranial pathology.[3]

Cold-stimulus Headache

Previously known as ice cream headache, cold-stimulus headache is a headache caused by a cold stimulus applied externally to the head or ingested or inhaled.[3] This headache was first described in 1944 by American neurologist Harold Wolff when he showed that the passage of cold solid or liquid over the palate and posterior pharyngeal wall could produce a headache in an experimental subject.[25]

External-traction Headache

External-traction headache results from sustained compression of, or traction upon, pericranial soft tissues.[3] This headache was first described in 2004 by German neurologist Joseph Norman Blau (1928–2010), but using the term ponytail headache.[26]

Primary Stabbing Headache

Primary stabbing headache is characterized by transient and localized stabs of pain in the head that occur spontaneously in the absence of organic disease of underlying structures or of the cranial nerves.[3] It was first described in 1964 by American ophthalmologist Richard K. Lansche as ophthalmodynia periodica, but, over the years, it has had other names.[27,28] In 1979, Sjaastad et al. used the term jabs and jolts syndrome, inspired by the descriptions of patients who complained of short lasting head pain ("jabs") or head pain so marked that it was accompanied by a shock-like feeling and even by head movement ("I have the jolts").[26] In 1980, Raskin and Schwartz used the term "ice-pick-like headache" to describe this same headache.[29]

Nummular Headache

Nummular headache was first described in 2002 by the Spanish neurologist Juan A. Pareja and colleagues.[30] Its main feature is that the pain is felt in a small rounded or elliptical area of about 2–6 cm in diameter, usually with well-defined borders. The pain is of mild or moderate intensity and it may course with periods of exacerbation or remission.[31]

Hypnic Headache

Hypnic headache was first described by American neurologist Neil H. Raskin in 1988.[32] It is characterized by recurrent nocturnal episodes of headache that periodically awaken the sleeping patient. Its pathogenesis is unknown.[33] It occurs for 10 or more days per month, for more than 3 months and lasts >15 minutes and for up to 4 hours after waking up. Lithium has a good therapeutic response in prophylaxis in 77.8% of patients.[3,34]

New Daily Persistent Headache

This is a persistent headache, daily from its onset, which is clearly remembered. The pain lacks characteristic features, and may be migraine-like or tension-type-like, or have elements of both.[3] New daily persistent headache was first described in 1986 by Canadian neurologist Walter John Vanast as a benign headache syndrome that usually remits without treatment.[35,36]

Epicrania Fugax

Epicrania fugax is a primary headache consisting of brief paroxysms, with stabbing quality, describing a linear or zigzag trajectory across the surface of 1 hemicrania. Diagnostic criteria for this headache have been proposed in the appendix section of ICHD-3.[3] It was first described by Juan Pareja et al. in 2008.[37]