Headache in the elderly

Although the prevalence is lower in the elderly than in young adults, headache is a common complaint in the aged population. A broad differential diagnosis and unique diagnostic considerations must be considered for the elderly patient with a complaint of headache. In addition, the evaluation and management of headache in older individuals must be considered in the context of comorbid conditions and polypharmacy, which are common in the elderly. As with children and young adults, headache classification in the elderly can be divided into primary and secondary headache disorders. The primary headache disorders consist of free-standing conditions such as migraine, cluster headache, and tension-type headache. Secondary headache disorders reflect underlying organic diseases such as giant cell arteritis, intracranial mass lesion, or metabolic abnormality. This article provides a review of the various etiologies, both primary and secondary, as well as guidelines for the treatment of headache in the elderly.