Primary Headache Attributed to External Compression or Traction to the Head: A Narrative Review.

Background: The aim of this review is to synthesize the existing knowledge regarding headaches attributed to external physical stimuli, as classified by the ICHD-3 (Group 4.6). Two forms can be distinguished in this group: (1) headache attributed to external compression and (2) headache attributed to external traction.

Methods: A comprehensive literature review was conducted using the Medline (PubMed) database and other relevant academic sources. All English-language articles were subjected to a relevance assessment.

Results: The prevalence of the two types of headache varies considerably, with a higher incidence observed in women or in the presence of predisposing factors (e.g., work with compulsory helmets or long hair). An external-compression headache is typically described as a pressing sensation, whereas an external-traction headache is characterized by a sensation of pulling. The headaches typically persist for less than an hour after the stimulus has ceased, and the intensity is typically reported as mild to moderate. Apart from avoiding the trigger, which is not always possible, effective therapies have not been established.

Conclusion: Both types of headaches are relatively common, yet they remain underrepresented in the scientific literature. Furthermore, there is a dearth of comprehensive overviews. If the triggering factor cannot be eliminated, both types of headaches can interfere with daily living and working.