Diagnostic criteria:
- Headache, no typical characteristics known, fulfilling criteria C-E
- Presence of post-traumatic stress disorder fulfilling DSM-IV criteria:
- the patient has been exposed to a traumatic event in which both of the following were present:
- the patient experienced, witnessed or was confronted with an event or events that involved actual or threatened death or serious injury, or a threat to the physical integrity of self or others
- the patient's response involved intense fear, helplessness or horror
- the traumatic event is persistently re-experienced in at least one of the following ways:
- recurrent and intrusive distressing recollections of the event, including images, thoughts or perceptions
- recurrent distressing dreams of the event
- acting or feeling as if the traumatic event were recurring (including a sense of reliving the experience, illusions, hallucinations and dissociative flashback episodes, including any of these that occur on awakening or when intoxicated)
- intense psychological distress at exposure to internal or external cues that symbolise or resemble an aspect of the traumatic event
- physiological reactivity on exposure to internal or external cues that symbolise or resemble an aspect of the traumatic event
- persistent avoidance of stimuli associated with the trauma and a numbing of general responsiveness (not present before the trauma), as indicated by at least three of the following:
- efforts to avoid thoughts, feelings or conversations associated with the trauma
- efforts to avoid activities, places or people that arouse recollections of the trauma
- inability to recall an important aspect of the trauma
- markedly diminished interest or participation in significant activities
- feeling of detachment or estrangement from others
- restricted range of affect (eg, unable to have loving feelings)
- sense of a foreshortened future (eg, not expecting to have a career, marriage, children or a normal life span)
- persistent symptoms of increased arousal (not present before the trauma), as indicated by at least two of the following):
- difficulty falling asleep or staying asleep
- irritability or outbursts of anger
- difficulty concentrating
- hypervigilance
- exaggerated startle response
- symptoms in B2, B3 and B4 have lasted >1 month
- the patient has been exposed to a traumatic event in which both of the following were present:
- Headache occurs exclusively during the course of the post-traumatic stress disorder
- Headache resolves after the post-traumatic stress disorder remits
- Headache is not attributed to another cause





