{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T17:16:12Z","timestamp":1787937372525,"version":"build-2784847793"},"reference-count":96,"publisher":"SAGE Publications","issue":"8","license":[{"start":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:00:00Z","timestamp":1785542400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:00:00Z","timestamp":1785542400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Cephalalgia"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Headache disorders are highly prevalent in patients with joint hypermobility, particularly in hypermobility spectrum disorders and hypermobile Ehlers\u2013Danlos syndrome, yet they remain frequently underrecognized in routine clinical practice. Failure to identify underlying hypermobility may lead to diagnostic oversimplification, delayed recognition of secondary headache mechanisms, and suboptimal therapeutic strategies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a narrative review with a structured literature search to synthesize current evidence on the epidemiology, clinical characteristics, pathophysiological mechanisms, and management of headache in patients with joint hypermobility.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In hypermobile populations, migraine is the most common primary headache phenotype; however, secondary causes, including spontaneous intracranial hypotension, craniocervical instability, temporomandibular dysfunction, Chiari malformation, and vascular complications, occur with increased frequency and require systematic consideration. Dysautonomia and orthostatic intolerance frequently interact with headache expression, contributing to clinical heterogeneity and management complexity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Recognition of joint hypermobility broadens the differential diagnosis of headache. We highlight key clinical red flags, outline a structured, mechanism-based approach to multimodal assessment, including musculoskeletal and autonomic evaluation, and discuss practical considerations for individualized management.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/03331024261477381","type":"journal-article","created":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T15:09:55Z","timestamp":1787670595000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Headache in patients with joint hypermobility"],"prefix":"10.1177","volume":"46","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7644-508X","authenticated-orcid":false,"given":"Welber Sousa","family":"Oliveira","sequence":"first","affiliation":[{"name":"Centro Especializado em Hipermobilidade e Dor, Bras\u00edlia, Federal District, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2103-9081","authenticated-orcid":false,"given":"Jan","family":"Hoffmann","sequence":"additional","affiliation":[{"name":"King's College London"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7028-9095","authenticated-orcid":false,"given":"Ang\u00e9lle Aragonez Essado","family":"J\u00e1como","sequence":"additional","affiliation":[{"name":"Centro Especializado em Hipermobilidade e Dor, Bras\u00edlia, Federal District, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0519-3871","authenticated-orcid":false,"given":"Raul De Omena","family":"Martins","sequence":"additional","affiliation":[{"name":"Department of Radiology, Hospital S\u00edrio Liban\u00eas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6826-8589","authenticated-orcid":false,"given":"Ricardo Henrique Almeida","family":"Barbosa","sequence":"additional","affiliation":[{"name":"Hospital da Crian\u00e7a de Bras\u00edlia"},{"name":"Medical Genetics Unit, Hospital Materno Infantil Dr. Ant\u00f4nio Lisboa, Bras\u00edlia, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0068-1905","authenticated-orcid":false,"given":"Mario F. 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