The comparison of precipitating and aggravating factors of headache according to sex, age, intensity, disease duration, and headache type

Abstract

Background & Objectives : Numerous precipitating and aggravating factors of headache have been established such as emotional stress, physical activity, fatigue, missing meals and menstruation. We conducted the present study to determine the difference of precipitating and aggravating factors of headache among patients with different age, sex, and headache type. Method : Twenty-two migraine with aura(MWA), 49 migraine without aura(MAA), and 101 tension-type headache(TH) patients (42.9 yr±14.5, diagnosed by IHS criteria) were investigated using a questionnaire. The questionnaire include the following precipitating and aggravating factors: physical activity, stress/tension, coughing/sneezing, fatigue, reading, driving, lack of sleep, specific foods/drinks, alcohol, missing meals, bending over, smoke, smell, light, noise, coitus, menstruation, and weather change. The patient with recent stroke, brain tumor, CNS infection and head trauma was excluded. Results : The common precipitating and aggravating factors were stress/tension (136), fatigue (87), lack of sleep (70), bending over (45), and weather change (42). Bending over, reading, specific foods/drinks, smoke, light, noise, weather change, and menstruation were increased in the MWA group and noise, weather change and menstruation in the MAA group with statistical significance. Menstruation and coughing/sneezing were more common in middle aged patients (30~55) than under 30. Stress and reading were more common in female. Coughing/sneezing, food/drink, coitus and menstruation were more common in patients group with moderate to severe intensity than mild. Fatigue, reading, missing meals, noise, weather change were more common in chronic headache group than recently developed. Conclusion : Although some headache patients have specific precipitating and aggravating factors corresponding to their headache type, age, sex, intensity, and disease duration, they usually have similar one such as stress/tension, fatigue, lack of sleep, bending over , menstruation, and weather change.