We studied the development of chronic daily headache in 258 headache practi
ce patients, 50 men and 208 women. Chronic daily headache was defined as he
adaches occurring at least 5 days per week for at least 1 year.
Twenty-two percent of the patients had daily headaches from the onset, and
78% initially experienced intermittent headaches. Of the patients with init
ially intermittent headaches, 19% experienced an abrupt transition into dai
ly headaches and 81% a gradual one. The distribution of the age of daily he
adache onset was the same in the patients with daily headaches from the ons
et and in those with initially intermittent headaches but with abrupt trans
ition into daily headaches. The distribution of the circumstances of daily
headache onset was also the same in the groups. The most common circumstanc
e of abrupt onset of daily headaches was head, neck, or back injury, in 61%
caused by a motor vehicle accident. In the patients with initially intermi
ttent headaches but with gradual transition into daily headaches, the trans
ition took an average of 10.7 years.