Three categories of chronic headache are
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The textbooks give a clear, authoritative answer. Here is the complete breakdown:
Three Categories of Chronic (Daily or Near-Daily) Headache
Chronic daily headache (CDH) is defined as headache occurring on 15 or more days per month. It is classified into three broad categories:
1. Primary CDH - Duration >4 hours/day
These are the most common forms of chronic headache without an identifiable underlying cause:
- Chronic migraine
- Chronic tension-type headache
- Hemicrania continua
- New daily persistent headache (NDPH)
(These four may all be complicated by medication overuse.)
2. Primary CDH - Duration <4 hours/day
Shorter-duration primary headache disorders that still qualify as chronic:
- Chronic cluster headache
- Chronic paroxysmal hemicrania
- SUNCT / SUNA (short-lasting unilateral neuralgiform headache attacks)
- Hypnic headache
3. Secondary CDH
Headache attributable to an identifiable underlying cause:
- Posttraumatic - head injury, iatrogenic, postinfectious
- Inflammatory - giant cell arteritis, sarcoidosis, Behcet's syndrome
- Chronic CNS infection
- Medication-overuse headache (the most common secondary cause in clinical practice)
In a pediatric context, Rosen's Emergency Medicine further subdivides chronic headache into chronic progressive (worrisome, suggests raised ICP or mass lesion) and chronic nonprogressive (typically benign, such as tension-type).
About 4% of adults experience daily or near-daily headache, making CDH a significant source of disability.
- Harrison's Principles of Internal Medicine 22E (2025), Table 17-3 - Classification of Daily or Near-Daily Headache
- Rosen's Emergency Medicine, Chronic Progressive / Nonprogressive Headache sections
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