4.5.1 Headache attributed to external application of a cold stimulus

Generalized headache following exposure of the unprotected head to a very low environmental temperature.

Diagnostic criteria:
A. At least two acute headache episodes fulfilling criteria B and C
B. Brought on by and occurring only during application of an external cold stimulus to the head
C. Resolving within 30 min after removal of the cold stimulus
D. Not better accounted for by another ICHD-3 diagnosis.

This headache is due to external cooling of the head, such as occurs during exposure in very cold weather, diving into cold water or receiving cryotherapy. Some patients develop intense, short-lasting, stabbing headache midfrontally, although the pain can be unilateral and temporal, frontal or retro-orbital.