2.3.2 Chronic tension-type headache not associated with pericranial tenderness

A 36-year-old solicitor reports a headache that has been recurring for the last few months without any new features. She locates it evenly on both sides of her head, describing it as a firm squeezing sensation with no beating or throbbing quality whatsoever. Once it starts it typically lasts for hours, and on a handful of occasions has continued essentially unbroken until she fell asleep. By her estimate this happens on about fifteen days each month, and it has been going on for roughly four months. She denied any nausea or vomiting and said that neither the department's bright lights nor the noise of the waiting room made her feel any worse, and pressing on her own scalp, temples or upper neck reveals no tenderness over the scalp, temples or upper neck.