Primary stabbing headache in a tertiary headache centre
Abstract
INTRODUCTION: Primary stabbing headache (PSH) is a short-lasting head pain occurring spontaneously in the absence of underlying structural causes. Although it is a frequent disorder, with a reported lifetime prevalence of 35.2% in the general population, its pathophysiological underpinnings remain incompletely understood. Notably, PSH frequently coexists with other primary headache disorders, particularly migraine, suggesting a possible shared biology.
METHODS: We retrospectively reviewed the medical records as a service evaluation of all patients diagnosed with PSH, using the International Classification of Headache Disorders, third edition, in our clinic between 2018 and 2025 as a service evaluation. Data on demographic variables and the presence of other primary headache disorders were collected and analysed. Concurrently, we conducted a systematic literature search according to PRISMA guidelines. A comprehensive search of PubMed/MEDLINE and EMBASE via Scopus through April 2025 identified studies examining the relationship between PSH and other primary headache disorders.
RESULTS: The retrospective analysis identified 68 patients who met the strict diagnostic criteria for PSH. Notably, 90% of these individuals were found to have a concomitant migraine diagnosis, while hemicrania continua (HC) and cluster headache (CH) were reported in 7% and 10% of cases, respectively. From the literature search, 27 eligible studies were included. Overall, a significant rate of…
How strong is the evidence?
Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 68 participants or records.
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