The structure of primary headaches according to data from the outpatient department of a neurological clinic

   Headache remains one of the major public health problems worldwide. Assessing the prevalence and structure of headaches is a fundamental step towards the effective organisation of medical care for patients with cephalalgia.

   Objective: to clarify the structure of primary headaches and clinical characteristics of migraine among patients attending outpatient clinics at neurological clinics.

   Material and methods. A cross-sectional study was conducted with an analysis of the electronic medical records of patients who visited the Consultative and Diagnostic Department (CDD) of the Russian Center of Neurology and Neuroscience (RCNN) with diagnoses according to the International Classification of Diseases, 10^th Revision (ICD-10): G43 (Migraine) and G44 (Other headache syndromes), verified according to the criteria of the International Classification of Headache Disorders, 3rd revision (ICHD-3).

   Results. In 2022, 22,445 patients sought treatment at the CDD RCNN. Headache was diagnosed in 2,830 (12.6%) people: migraine in 1,325 (46.82 %), tension-type headache (TTH) – in 1,147 (40.53 %), trigeminal autonomic cephalalgia (TAC) – in 36 (1.27 %), other types of headache – in 322 (11.38 %). Most patients with headaches were women (71.55 %) aged 40.89 ± 18.12 years. Migraine without aura (G43.0) was detected in 52.61 %, migraine with aura (G43.1) – in 21.66 %, other migraine (G43.8) in 8.37 %, unspecified migraine (G43.9) in 15.93 %, and complicated migraine (G43.3) in 1.43 % of people. The average frequency of headaches was 17.60 ± 6.91 days per month. Rare episodic migraine was observed in 552 (37.05 %) patients, frequent episodic migraine in 282 (21.28 %) patients, and chronic migraine in 491 (41.67 %) patients. Most patients had a long history of the disease (17.10 ± 8.22 years), and about 70 % did not receive preventive treatment before contacting the RCNN.

   Conclusion. The study highlighted the problem of late referral of migraine patients for specialised care and the chronicity of the disease. Further systematic study of the prevalence and structure of headaches is important for the development of effective strategies for the diagnosis and treatment of primary cephalalgia.

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