Clinical Patterns, Risk Factors, Diagnostic Utilization, and Short-Term Outcomes of Headache Disorders: A Prospective Observational Study of 450 Patients Attending a Neurosurgical Outpatient Clinic in Iraq

Abstract

Background: Headache disorders are among the most common neurological conditions worldwide and represent a major cause of disability and healthcare utilization. Data regarding headache patterns and treatment outcomes in Iraqi outpatient neurosurgical settings remain limited. Objectives: To evaluate the distribution of headache disorders associated risk factors, diagnostic approaches, and short-term treatment outcomes among patients attending a private neurosurgical clinic in Iraq. Materials and Methods: A prospective observational study was conducted between June 1, 2025, and December 1, 2025. A total of 450 consecutive patients presenting with headaches were enrolled. Diagnoses were established according to the International Classification of Headache Disorders, Third Edition (ICHD-3). Demographic characteristics, headache subtype, risk factors, imaging findings, and treatment outcomes were recorded. Statistical analysis was performed using descriptive and comparative methods, with statistical significance defined as p<0.05. Results: The study included 276 females (61.3%) and 174 males (38.7%), with a mean age of 34.8 ± 12.6 years. Tension-type headache was the most common diagnosis (39.1%), followed by migraine (34.0%), cervicogenic headache (12.0%), medication-overuse headache (7.1%), cluster headache (3.1%), and secondary headaches (4.7%). Stress and sleep disturbance were identified in 62% of patients, while family history was reported in 48% of migraine cases. Clinical improvement was observed in 72% of tension-type headache patients, 65% of migraine patients, 78% of cervicogenic headache patients, 69% of medication-overuse headache patients, and 57% of cluster headache patients. Conclusion: Primary headache disorders constituted the majority of cases in this Iraqi outpatient population. Appropriate clinical assessment and individualized treatment strategies resulted in favorable short-term outcomes for most patients.