11.1 Headache attributed to disorder of cranial bone

Headache caused by a disorder or lesion of the cranial bones.

Diagnostic criteria:
A. Any headache fulfilling criterion C
B. Clinical, laboratory and/or imaging evidence of a disorder or lesion of the cranial bones known to be able to cause headache
C. Evidence of causation demonstrated by at least two of the following:

    1. headache has developed in temporal relation to the onset of the cranial bone disorder or appearance of the lesion
    2. either or both of the following:

      a) headache has significantly worsened in parallel with worsening of the cranial bone disorder or lesion
      b) headache has significantly improved in parallel with improvement in the cranial bone disorder or lesion

    3. headache is exacerbated by pressure applied to the cranial bone lesion
    4. headache is localized to the site of the cranial bone lesion

D. Not better accounted for by another ICHD-3 diagnosis.

Most disorders of the skull (eg, congenital abnormalities, fractures, tumours, metastases) are usually not accompanied by headache. Exceptions of importance are osteomyelitis, multiple myeloma and Paget’s disease. Headache may also be caused by lesions of the mastoid, and by petrositis.