Primary Stabbing Headache

  • Danielle Murray
  • Esma DilliEmail author
Headache (R.B. Halker Singh, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Headache


Purpose of Review

To provide a comprehensive and updated review of the literature on primary stabbing headache.

Recent Findings

Changes to the ICHD-3 criteria have resulted in increased sensitivity to capture primary stabbing headache (PSH). According to the ICHD-3, the sharp stabbing pain is no longer restricted to the first division of the trigeminal nerve. Age, gender, and co-morbidities such as migraine seem to influence the prevalence of PSH. Subclassification into monophasic, intermittent, and chronic forms have been proposed in a recent prospective study and may be helpful from a prognostication perspective; however, further studies are required.


Secondary etiologies for stabbing headaches are part of the differential diagnosis of primary stabbing headache; therefore, it is reasonable to perform neuroimaging. For severe frequent attacks, indomethacin continues to be considered first line. Other treatment options include COX2 inhibitors and melatonin.


Primary stabbing headache Idiopathic stabbing headache Ice pick headache Jabs and jolts headache Sharp short-lived head pain 


Compliance with Ethical Standards

Conflict of Interest

Esma Dilli reports honoraria from Allergen and royalties from Lippincott. Danielle Murray reports no potential conflicts of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.


Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Authors and Affiliations

  1. 1.Division of NeurologyUniversity of British ColumbiaVancouverCanada

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