{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T19:32:14Z","timestamp":1791401534017,"version":"4.3.3"},"reference-count":29,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,8,21]],"date-time":"2023-08-21T00:00:00Z","timestamp":1692576000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>Real-life headache presentations may fit more than one ICHD3 diagnosis. This project seeks to exhaustively list all logically consistent \u201cco-diagnoses\u201d according to the ICHD3 criteria. We limited our project to cases of two concurrent diagnoses.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We included the criteria for \u201cMigraine\u201d (1.1, 1.2, 1.3), \u201cTension-type headache\u201d (2.1, 2.2, 2.3, 2.4), \u201cTrigeminal autonomic cephalalgias\u201d (3.1, 3.2, 3.3, 3.4, 3.5), and \u201cOther primary headache disorders.\u201d We also excluded \u201cprobable\u201d diagnosis criteria. Each characteristic in the above criteria is assigned a unique prime number. We then encoded each ICHD3 criteria into integers through multiplication in a list format; we called these criteria representations. \u201cCodiagnoses representations\u201d were generated by multiplying all possible pairings of criteria representations. We then manually encoded a list of logically inconsistent characteristics through multiplication. All co-diagnoses representations divisible by any inconsistency representations were filtered out, generating a list of co-diagnoses representations that were logically consistent. This list was then translated back into ICHD3 diagnoses.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We used a total of 103 prime numbers to encode 578 ICHD3 criteria. Once illogical characteristics were excluded, we obtained 145 dual diagnoses. Of the dual diagnoses, two contained intersecting characteristics due to subset relationships, 14 contained intersecting characteristics without subset relationships, and 129 contained dual diagnoses as a result of non-intersecting characteristics.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Analysis of dual diagnosis in headaches offers insight into \u201cloopholes\u201d in the ICHD3 as well as a potential explanation for the source of a number of controversies regarding headache disorders. The existence of dual diagnoses and their identification may carry implications for future developments and testing of machine-learning diagnostic algorithms for headaches.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fneur.2023.1221209","type":"journal-article","created":{"date-parts":[[2023,8,21]],"date-time":"2023-08-21T10:17:58Z","timestamp":1692613078000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":9,"title":["Which headache disorders can be diagnosed concurrently? An analysis of ICHD3 criteria using prime encoding system"],"prefix":"10.3389","volume":"14","author":[{"given":"Pengfei","family":"Zhang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2023,8,21]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"219","DOI":"10.1007\/s10194-009-0104-8","article-title":"Coexistence of cluster headache and paroxysmal hemicrania: does it exist? 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New Daily Persistent Headache Starting as a Single Thunderclap Headache (3 New Cases)","volume":"59","author":"Jamali","year":"2019","journal-title":"Headache"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"607","DOI":"10.1038\/s41582-019-0243-8","article-title":"Post-traumatic headache: epidemiology and pathophysiological insights","volume":"15","author":"Ashina","year":"2019","journal-title":"Nat Rev Neurol"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"386","DOI":"10.1111\/j.1468-2982.2004.00860.x","article-title":"Trigeminal Autonomic Cephalalgias: A Case Of Post-Traumatic SUNCT Syndrome? 2","volume":"25","author":"Putzki","year":"2005","journal-title":"Cephalalgia"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"572","DOI":"10.1136\/jnnp-2019-322725","article-title":"New insights in post-traumatic headache with cluster headache phenotype: a cohort study","volume":"91","author":"Grangeon","year":"2020","journal-title":"J Neurol Neurosurg Psychiatry"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"831","DOI":"10.1111\/joor.13324","article-title":"Diagnosis and management of traumatically induced hemicrania continua and neuropathic pain secondary to facial gun shot wound","volume":"49","author":"Heir","year":"2022","journal-title":"J Oral Rehabil"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"273","DOI":"10.1212\/wnl.56.2.273","article-title":"Post-traumatic chronic paroxysmal hemicrania (CPH) with aura","volume":"56","author":"Matharu","year":"2001","journal-title":"Neurology"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"50","DOI":"10.1186\/s10194-018-0875-x","article-title":"Medication-overuse headache: a widely recognized entity amidst ongoing debate","volume":"19","author":"Vandenbussche","year":"2018","journal-title":"J Heaache Pain"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"e1002264","DOI":"10.1371\/journal.pbio.1002264","article-title":"Meta-research: Evaluation and Improvement of Research Methods and Practices","volume":"13","author":"Ioannidis","year":"2015","journal-title":"PLoS Biol"},{"key":"ref27","doi-asserted-by":"publisher","first-page":"818","DOI":"10.1177\/0333102420911461","article-title":"Unrecognized challenges of treating status migrainosus: An observational study","volume":"40","author":"Iljazi","year":"2020","journal-title":"Cephalalgia"},{"key":"ref28","doi-asserted-by":"publisher","first-page":"14062","DOI":"10.1038\/s41598-020-70992-1","article-title":"Machine learning-based automated classification of headache disorders using patient-reported questionnaires","volume":"10","author":"Kwon","year":"2020","journal-title":"Sci Rep"},{"key":"ref29","doi-asserted-by":"publisher","first-page":"870","DOI":"10.1111\/head.14324","article-title":"Diagnostic accuracy of an artificial intelligence online engine in migraine: A multi-center study","volume":"62","author":"Cowan","year":"2022","journal-title":"Headache"}],"updated-by":[{"DOI":"10.3389\/fneur.2024.1404283","type":"corrigendum","label":"Corrigendum","source":"publisher","updated":{"date-parts":[[2024,4,8]],"date-time":"2024-04-08T00:00:00Z","timestamp":1712534400000}}],"container-title":["Frontiers in Neurology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fneur.2023.1221209\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,4,8]],"date-time":"2024-04-08T14:47:49Z","timestamp":1712587669000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fneur.2023.1221209\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,8,21]]},"references-count":29,"alternative-id":["10.3389\/fneur.2023.1221209"],"URL":"https:\/\/doi.org\/10.3389\/fneur.2023.1221209","relation":{"corrigendum":[{"id-type":"doi","id":"10.3389\/fneur.2024.1404283","asserted-by":"object"}]},"ISSN":["1664-2295"],"issn-type":[{"value":"1664-2295","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,8,21]]},"article-number":"1221209"}}