2.1.1 Infrequent episodic tension-type headache associated with pericranial tenderness

A 40-year-old civil engineer reports a history of headache spells going back many years. The patient describes a squeezing, vice-like pressure rather than any pulsing quality, moderate at worst and never severe, occurring far less than once a month on average. He denies any particular sensitivity to light or sound during attacks, and there has been no nausea or vomiting whatsoever. He reckons he has experienced at least eleven such headache days over his lifetime, with durations ranging from roughly forty minutes up to nearly four days on one memorable occasion. He also mentions that firm palpation over his scalp and neck muscles clearly reproduced his usual discomfort, as the patient describes it.