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primary stabbing headache; ice-pick headache
Epidemiology:
- more common among persons with history of migraine
Clinical manifestations:
- transient localized stabs of head pain
- pain may occur anywhere on the head, including the eye
- the face is generally spared
- duration = seconds, but may be up to 1-2 minutes
- less localized dull pain lasting minutes may follow
- frequency generally < daily, but attacks may occur in series
- periods of exacerbations & remissions common
- no cranial autonomic symptoms (lacrimation or tearing)
Differential diagnosis:
- cluster headache
- duration of 15 minutes to 3 hours
- mean duration 1 hour
- pain reaches a peak in about 10-15 min & lasts 45-60 min
- cranial autonomic symptoms (lacrimation or tearing)
Management:
- generally no treatment necessary
- indomethacin may be helpful
General
headache
References
- Medical Knowledge Self Assessment Program (MKSAP) 18,
American College of Physicians, Philadelphia 2018
- Medical Knowledge Self Assessment Program (MKSAP) 20
American College of Physicians, Philadelphia 2025
- Chua AL, Nahas S.
Ice Pick Headache.
Curr Pain Headache Rep. 2016 May;20(5):30. Review.
PMID: 27038969
- Kwon S, Lee MJ, Kim M.
Epicranial headache part 1: primary stabbing headache.
Cephalalgia. 2023;43:3331024221146985.
PMID: 36756957