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Nummular headache is a rather rare type, related to primary headaches according to the International Classification of Headache Disorders - III. Many aspects of nummular headache have not been studied, medical practitioners are unfamiliar with the clinical features and approaches to therapy. Statistics of this type of cephalgia in children is unknown. The article analyzes the literature data of recent years related to this problem. The details of the clinical features are considered using a case example.

The article is devoted to the current state of the problem of systematization of primary headaches and main clinical forms. The conceptual evolution of ideas about the classification of certain options of cephalgia and identified major trends for its improvement is given. Verification of types and subtypes of individual cephalgia can present a significant challenge even for experienced neurologists, neurosurgeons, and internists. In this regard in most European countries and the US. have set up specialized centers for the treatment of headaches. Concluded that in the short term in the national health care system, including. Including the Armed Forces, it is advisable to create such centers.

190 patients with hypothalamic insufficiency were investigated. The character, frequency of various forms of headache as well as its correlation with neuroendocrine emotional motivation and vegetative disorders were analysed. It was found that headache occurred more frequently in patients with hypothalamic insufficiency (66%) than in the whole population (5-20%). This confirms the role of diencephalic disfunction in its genesis. Psychovegetative disturbances were expressed most of all in tension-type headache (TTH). Very likely that some psychoendocrine mechanisms (particularly depression and idiopathic edema) play important role in pathogenesis of TTH. Clinical effect of Lerivon confirms the pathogenetic role of depression in these cases.

Fifty-four patients aged 25 to 66 years suffering from hemicrania were examined. 21 patients showed certain changes in the clinical picture and course of hemicrania itself: enhancement of paroxysms or transformation of one form of hemicrania to the other one, more severe (e.g. a simple form transforms to an ophthalmic or an associated one). In 15 patients, ++vegeto-dystonic manifestations associated mostly with a significant reduction of migrainous paroxysms themselves and, more rarely, with their dramatic enhancement began with time to play the leading part in the disease clinical picture. Superimposition of essential hypertension or atherosclerosis was also coupled with changes in the course of hemicrania, in particular by an increase of the period of cephalgia and appearance of constant headaches.