Clinical Diagnosis and Management of Migraines and Headaches

Dear Colleagues,

Headaches and migraines are among the most frequent human disorders. The current third edition of the International Classification of Headache Disorders recognizes 367 main forms of headache. Primary headaches are diseases in their own right. They are responsible for over 92% of all headaches. Migraine is a particularly disabling neurological disorder. It can occur in 48 subtypes and can severely disable sufferers for decades of their lives. The World Health Organization classifies migraine as the most disabling disease in women between the ages of 15 and 49. Migraine affects more than 15% of the global population within a year. It occurs in recurrent attacks. The characteristics are severe pain intensity, aggravation by physical activity, nausea, vomiting, hypersensitivity to noise and light, as well as a variety of physical and psychological symptoms over a period of typically 4–72 h. In addition, transient focal neurological symptoms can occur in a third of those affected. Numerous comorbid conditions can accompany migraine. These include depression, epilepsy, stroke, myocardial infarction, and other vascular diseases. In recent years, fascinating new insights have been gained into the development and maintenance of primary headaches. Key findings include the role of trigeminovascular activation, spreading depolarization, the importance of CGRP, the clinical manifestation of peripheral and central sensitization, pathomechanisms in the brainstem and midbrain, and the role of intracranial blood vessels and cerebral blood flow. At the same time, extensive findings on the genetic basis of migraines and headaches have been developed. All this has led to ground-breaking new diagnostic and therapeutic possibilities in the care of migraine and headache patients. The treatment of migraine and headache involves a combination of education, knowledge, and behavior, as well as acute and preventive pharmacological therapies. Understanding the mechanisms of migraine and headache has led to the identification of important classes of new drugs. These include triptans, monoclonal antibodies against CGRP mechanisms, gepants, ditans, and others.

This Special Issue on "Clinical Diagnosis and Management of Migraines and Headaches" aims to highlight recent developments in the diagnosis and treatment of migraine and headache. The articles are intended to help implement the new findings directly into the clinical and practical care of migraine and headache patients.

Prof. Dr. Hartmut Göbel
Guest Editor

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• migraine
• headache
• classification
• pathophysiology
• diagnosis
• treatment
• comorbidity