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The relevance of these three predictors in the development and maintenance of headache was repeatedly confirmed in several prior studies [21, 63, 64].
It would be possible that nociceptive afferences originating in cervical structures may influence the excitability of the trigeminal nucleus caudalis, further promoting the maintenance of headache.
Additionally, for children suffering from headache already at baseline, the identification of possible factors that contribute to the maintenance of headache is crucial.
On the other hand, Wayne Holder and others [54] underline the influence of parental behaviour in the maintenance of headache in childhood.
Due to the possible influence of the cervical spine in the development or maintenance of headache, further studies of neck mobility in children with tension type headache are required.
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Moreover, prior studies reported the importance of parental headache in the development and maintenance of paediatric headache [23, 67].
The release leads to activation of nociceptors producing both generation and maintenance of the headache [11, 16].
This neurophysiological model of sensitization of the trigemino-cervical nucleus caudalis is generally presumed to play an important role in the onset and maintenance of chronic headaches including migraine and chronic tension-type headache (TTH) [7, 8].
Contemporary perspectives on the etiology and maintenance of primary headaches in children continue to be founded on a model that integrates genetic and biological predisposition with psychosocial context [5].
Overuse of acute medication is responsible for the development or maintenance of chronic daily headache (CDH) and successful detoxification results in a 70% return to an episodic pattern of migraine [19].
Eligible subjects are instructed in the maintenance of a daily headache diary for eight consecutive weeks while continuing usual care.
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