Secondary headaches in the elderly

The prevalence of headache decreases with age. However, headache is still ranked as one of the most frequent complaints in the elderly. Aging is accompanied by a decline in the incidence of most primary headache disorders and by an increase in organic causes of headache, especially after 55–60 years of age. New onset headaches or a change in headache pattern in this age group carries a high index of suspicion for organic diseases. A broad differential diagnosis and unique diagnostic considerations must be considered. Secondary headache disorders reflect underlying organic diseases such as giant cell arteritis, intracranial mass lesion, cerebrovascular diseases or metabolic abnormality.