23. Management of Headache in the Elderly

  1. Matthew S. Robbins MD,
  2. Brian M. Grosberg MD and
  3. Richard B. Lipton MD
  1. Matthew S. Robbins and
  2. Richard B. Lipton

Published Online: 19 JUL 2013

DOI: 10.1002/9781118678961.ch23



How to Cite

Robbins, M. S. and Lipton, R. B. (2013) Management of Headache in the Elderly, in Headache (eds M. S. Robbins, B. M. Grosberg and R. B. Lipton), John Wiley & Sons, Ltd, Oxford, UK. doi: 10.1002/9781118678961.ch23

Editor Information

  1. Montefi ore Headache Center, Saul R. Korey Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, USA

Author Information

  1. Albert Einstein College of Medicine, Bronx, NY, USA

Publication History

  1. Published Online: 19 JUL 2013

ISBN Information

Print ISBN: 9780470654729

Online ISBN: 9781118678961



  • headache;
  • elderly;
  • giant cell arteritis;
  • migraine;
  • tension-type;
  • cluster headache;
  • hypnic headache;
  • chronic daily headache


The approach to the elderly patient presenting with headache is a unique management challenge and first relies on achieving the proper diagnosis. As secondary disorders are more common in older patients, new onset headache in this age group requires diagnostic vigilance. Incident primary headache disorders are less common in the elderly but do occur, and primary headache disorders such as migraine may persist into late life. The treatment of headache disorders in the older patient can be complex. Medical comorbidities, polypharmacy, and derangements of drug metabolism and clearance often limit medication choices. In this chapter we first briefly address secondary headache disorders in this age group, and then discuss primary headache disorders in the context of their epidemiology, clinical features, and management strategies. We outline a multifaceted approach, including the use of acute, transitional, and preventive medications, interventional and nonpharmacological techniques, and addressing risk factors for headache progression and perpetuation.