Primary care for women. Assessment and management of headache.

Headache is the seventh leading presenting complaint for ambulatory care encounters in the United States, which accounts for 18.3 million, or 43.2 per 1000, outpatient visits per year. Headache disorders have historically been difficult to tract and study. This problem has been greatly ameliorated since the development, in 1988, of the international headache classification of the International Headache Society. Tension-type headache and migraine headache predominantly affect women, whereas cluster headache predominantly affects men. Advances both in diagnosis and in treatment modalities such as prophylactic treatments, stress reduction and biofeedback, and the use of sumatriptan, have helped to make the management of headache appropriate for nurse-midwives in the primary care setting.