2.1.1 Infrequent episodic tension-type headache associated with pericranial tenderness

A 51-year-old florist reports headaches possibly linked to eyesight concerns. The patient describes a tight, band-like pressure gripping both sides of her head, which she likens to wearing a hat that is a size too small. These headache days have been infrequent throughout her adult life, turning up at a rate well under one day per month, and she counts at least fourteen such episodes altogether. On the occasions they occur, the pain has lasted anywhere between fifty minutes and roughly two days. She notices no marked aversion to light and no particular dislike of loud noise when it happens, and there has been no nausea or vomiting with any episode. Manual pressure over her temples and the muscles at the back of her neck clearly reproduced the familiar tenderness, she adds, when she pressed there herself, as the patient describes it.