Expert Commentary

Management of Headache in the Elderly

Matthew S. Robbins, MD

The Montefiore Headache Center
Saul R. Korey Department of Neurology
Albert Einstein College of Medicine
Bronx, NY


Diagnosis and management of headache can be challenging in older patients. New-onset headache is rare in this population and is usually a symptom of another disorder. All patients, therefore, should undergo neurologic and physical evaluations to screen for secondary disorders. Among primary headache disorders, tension-type headache is the most prevalent in the elderly. Management of headache disorders in older patients is complicated by high comorbidity rates and almost ubiquitous use of multiple medications; consideration of drug-drug interactions is therefore critical. Clinicians should also address risk factors associated with the transformation of headache from episodic to chronic. Here, Dr. Robbins discusses diagnostic and management challenges in elderly patients as well as available treatment options for headache disorders.


  1. Robbins MS, Lipton RB. Management of headache in the elderly. Drugs Aging. 2010;27(5):377-398.
  2. Tonini MC, Bussone G. Headache in the elderly: primary forms. Neurol Sci. 2010;31 (suppl 1):S67-71.
  3. Tanganelli P. Secondary headaches in the elderly. Neurol Sci. 2010;31 (suppl 1):S73-6.
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