The International Headache Society gives the following symptoms for tension headache:
- Pain usually bilateral (often fronto-occipital; toward forehead (frontal), occiput (occipital); sometimes headband-like).
- Pain character: dull, pressing and pulling pain.
- Pain intensity: mild to moderately intense pain.
- Attack frequency: usually occurs over days or weeks. The pain leads to most sufferers that performance and well-being are limited.
- Physical activity (eg, climbing stairs or similar physical activities) does not worsen the pain, but improves it.
- Possible muscle tension in the neck and neck.
- Depressive mood
Tension headache in old age
In episodic or chronic tension headache remember that it may be a secondary headache disorder.
Warning signs (red flags) [quick reference.]
- Anamnestic information:
- Tumor disease
- Immunosuppression (suppression of the body’s own defense system).
- Continuous medication: anticoagulation
- Headache onset > 50 years of age
- Clinical findings:
- No clear diagnosis or atypical presentation.
- Neurologic abnormalities: Seizures, brain-organic psychosyndrome (HOPS; collective term for mental and psychosocial disorders as a result of organic brain changes), focal neurological deficit without papilledema (congestive papilla; edematous swelling of the optic nerve papilla (papilla nervi optici) at the exit site of the optic nerve from the eyeball).
- Abrupt explosive onset
- Continuous headache
- Other findings:
- Fever
- Increased blood cell sedimentation rate
- For a comprehensive account of the trademarks, see below Cephalgia (headache).