The prevalence of hesdache in the elderly is lower than in the younger age groups. However any new headache or change in headache symptoms carries a greater probability of being a sign of another ...primary disease. Among primary headaches the tension type is more frequent than migraine (but the latter is less frequent than secondary headaches). Hypnic headache is a rare type of primary headache described exclusively in the elderly. It occurs (quite regularly) at night, being 15-60 minutes in length, diffuse, often pulsating; and not accompanied by autonomic symptoms. Treatment consists of a single evening dose of lithium. Above 65 years of age up to 15% of headaches are secondary, being a consequence of cerebrovascular disease, giant-cell arteritis, neoplasm, subdural hematoma, etc. Therefore, a careful history and examination are mandatory. In patients over 50 years of age at the onset of headache the sedi mentation rate should be measured. Also, the physician's "indication threshold" CT should belower than in the younger age group of patients suffering headache. The elderly take a largrer amount of drugs more regularly and headache may be a side effect. The principles of headache treatment are similar to those in the adult population in general and the contraindications (and the possibility of drug interactions) are more prevalent in the elderly.
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