Open Access Open Badges Research article

Management of secondary chronic headache in the general population: the Akershus study of chronic headache

Espen Saxhaug Kristoffersen12*, Christofer Lundqvist1345, Kjersti Aaseth1, Ragnhild Berling Grande1 and Michael Bjørn Russell13

Author Affiliations

1 Head and Neck Research Group, Research Centre, Akershus University Hospital, PO Box 95,, 1478, Lørenskog, Norway

2 Department of General Practice, Institute of Health and Society, University of Oslo, Oslo, Norway

3 Institute of Clinical Medicine, Campus Akershus University Hospital, University of Oslo, Nordbyhagen, Norway

4 HØKH, Research Centre, Akershus University Hospital, Lørenskog, Norway

5 Department of Neurology, Akershus University Hospital, Lørenskog, Norway

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The Journal of Headache and Pain 2013, 14:5  doi:10.1186/1129-2377-14-5

Published: 30 January 2013



The prevalence of secondary chronic headache in our population is 0.5%. Data is sparse on these types of headache and information about utilisation of health care and medication is missing. Our aim was to evaluate utility of health service services and medication use in secondary chronic headache in the general population.


An age and gender stratified cross-sectional epidemiological survey included 30,000 persons 30–44 years old. Diagnoses were interview-based. The International Classification of Headache Disorders 2nd ed. was applied along with supplementary definitions for chronic rhinosinusitis and cervicogenic headache. Secondary chronic headache exclusively due to medication overuse was excluded.


One hundred and thirteen participants had secondary chronic headache. Thirty % had never consulted a physician, 70% had consulted their GP, 35% had consulted a neurologist and 5% had been hospitalised due to their secondary chronic headache. Co-occurrence of migraine or medication overuse increased the physician contact. Acute headache medication was taken by 84% and 11% used prophylactic medication. Complementary and alternative medicine was used by 73% with the higher frequency among those with than without physician contact.


The pattern of health care utilisation indicates that there is room for improving management of secondary chronic headache.

Secondary chronic headache; Chronic migraine; Medication-overuse headache; Health care utilisation; General population