Resumo
Definição
History and exam
Key diagnostic factors
- presença de fatores de risco
- dor de cabeça generalizada
- dor de cabeça frontal ou occipital
- dor de cabeça não pulsátil
- dor constritiva
- exame neurológico normal
Other diagnostic factors
- sensibilidade pericraniana
- sensibilidade do músculo esternocleidomastoideo
- sensibilidade do músculo trapézio
- sensibilidade do músculo temporal
- sensibilidade do músculo pterigoideo lateral
- sensibilidade do músculo masseter
- fotofobia ou fonofobia
- náuseas
- uso regular de analgésicos
- ansiedade e depressão
- Somatização
Risk factors
- tensão mental
- estresse
- pular refeições
- fadiga
- privação de sono
- Somatização
- sexo feminino
- idade 20-39 anos
- situação socioeconômica baixa
- uso excessivo de analgésicos
Diagnostic tests
1st tests to order
- diagnóstico clínico
Tests to consider
- tomografia computadorizada (TC) dos seios da face
- ressonância nuclear magnética (RNM) cranioencefálica
- punção lombar
- polissonografia
Treatment algorithm
ataque agudo
sintomas crônicos (>7 a 9 dias de cefaleia/mês)
Contributors
Authors
Mark W. Green, MD, FAAN

Professor of Neurology, Anesthesiology and Rehabilitation Medicine
Emeritus Director of Headache and Pain Medicine
Icahn School of Medicine at Mount Sinai
New York
NY
Disclosures
MWG declares that he has no competing interests.
Rachel Colman, MD
Assistant Professor of Neurology
Icahn School of Medicine at Mount Sinai
New York
NY
Disclosures
RC declares that she has no competing interests.
Peer reviewers
Sait Ashina, MD
Assistant Professor of Neurology and Anesthesia
Harvard Medical School
Director of Comprehensive Headache Center
Beth Israel Deaconess Medical Centre
Boston
MA
Disclosures
SA has received honoraria from and is a consultant for Abbvie/Allergan, Eli Lilly, Linpharma, Lundbeck, Satsuma, Teva, Theranica, Percept, and Impel NeuroPharma. SA is an author of one of the references in this topic.
Giles Elrington, MBBS (Hons), MD, FRCP
Consultant Neurologist
Barts Health NHS Trust
London
UK
Disclosures
GE is involved in a number of clinical trials on multiple sclerosis sponsored by Genzyme, Roche, Teva, Novartis, Biogen, as well as one funded by the MRC. He is also involved in clinical trials sponsored by Allergan, NMT Medical, GlaxoSmithKline (GSK), Bristol-Myers, the UK's Parkinson's Disease Research Group, and Pharmacia. In addition, he has attended lectures, conferences, and symposia with the following companies: GSK, AstraZeneca, MSD, Almirall, Pfizer, Menarini, Allergan, Biogen, Teva, Conference Plus, Infomed, BMJ.
Paul Davies, MA, MD, FRCP
Consultant Neurologist
Northampton General Hospital
Northampton
UK
Disclosures
PD declares that he has no competing interests.
Peer reviewer acknowledgements
BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.
Disclosures
Peer reviewer affiliations and disclosures pertain to the time of the review.
References
Key articles
Headache Classification Committee of the International Headache Society (IHS) The International Classification of Headache Disorders, 3rd edition. Cephalalgia. 2018 Jan 25;38(1):1-211.Full text
Ashina S, Mitsikostas DD, Lee MJ, et al. Tension-type headache. Nat Rev Dis Primers. 2021 Mar 25;7(1):24. Abstract
Bendtsen L, Evers S, Linde M, et al. EFNS guideline on the treatment of tension-type headache - report of an EFNS task force. Eur J Neurol. 2010 Nov;17(11):1318-25.Full text Abstract
Headaches in pregnancy and postpartum: ACOG clinical practice guideline No. 3. Obstet Gynecol. 2022 May 1;139(5):944-72. Abstract
Banzi R, Cusi C, Randazzo C, et al. Selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs) for the prevention of tension-type headache in adults. Cochrane Database Syst Rev. 2015;(5):CD011681.Full text Abstract
Linde K, Allais G, Brinkhaus B, et al. Acupuncture for the prevention of tension-type headache. Cochrane Database Syst Rev. 2016;(4):CD007587.Full text Abstract
Reference articles
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
Differentials
- Enxaqueca crônica
- Cefaleia por uso excessivo de medicamentos
- Sinusite esfenoidal
More DifferentialsGuidelines
- Headaches in over 12s: diagnosis and management
- Headaches in pregnancy and postpartum: ACOG clinical practice guideline No. 3
More GuidelinesPatient information
Cefaleia tensional
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