Abstract

Background: Headache disorders, particularly migraine and tension-type headaches (TTH), are
major global health concerns. The burden of migraine and TTH in the Middle East exceeds the global average. The present study aimed to evaluate the prevalence, clinical features, and radiological findings of primary headache disorders comparing regional clinical and epidemiological characteristics with national and international studies to improve the treatment strategies in the Middle East.

Methods: A single-centre retrospective cohort study analyzed headache patients over 34 months. Clinical presentations, radiological features, and patient parameters were recorded and evaluated.

Results: Among 1,500 patients, 73.6% had migraines, 20.6% had TTH, and 5.5% had trigeminal
autonomic cephalalgia (TAC). Migraine prevalence peaked between ages 20 and 25 (28.1%), while TTH (29.19%) and TAC (28.2%) were most common between ages 36 and 40. Migraine (59.8%) and TTH (57.9%) were more prevalent in females, while TAC (51%) and other primary headaches (83.3%) were more common in males. Positive family history was noted in migraine (63.8%) and TAC (22.2%). Migraine was often aggravated by head bathing and lack of sleep (23.3%), while TTH and TAC were triggered by physical stress (43.7%), and sunlight exposure (37%). MRI findings were normal in 85.6% of all headache types and 99.6% of migraines without aura. In contrast, migraines with aura showed white matter hyperintensities (WMH) in 95.96% of cases.

Conclusion: The study highlights a high prevalence of migraines, though lower than global estimates. Clinically significant MRI findings were observed in migraines with aura, aligning with international data. Multi-centre studies are required to further refine treatment strategies.

Keywords: Global health, Headache disorders, Migraine disorders, Prevalence, Tension-type headache, Trigeminal autonomic cephalalgias