Original Paper

Received: August 26, 2009

Accepted: March 8, 2010
Published online: June 3, 2010

Neuroepidemiology 2010;35:5965
DOI: 10.1159/000310940

Prevalence of Migraine, Probable

Migraine and Tension-Type Headache
in the Croatian Population
VlastaVukovi a DavorPlavec b SandaPavelin c DavorJanuljak d
MiraIvankovi e VidaDemarin a

Department of Neurology, University Hospital Sestre milosrdnice, Reference Centers for Headaches and
Neurovascular Disorders of the Ministry of Health of the Republic of Croatia, and b Research Department, Childrens
Hospital Srebrnjak, Zagreb, c Department of Neurology, University Hospital Split, Split, d Department of Neurology,
University Hospital Osijek, Osijek , and e Department of Neurology, General Hospital Dubrovnik, Dubrovnik , Croatia

Key Words
Migraine Probable migraine Tension-type headache
Croatia

Abstract
Background/Aim: Population-based epidemiological studies about headaches, especially migraine, have been carried
out in many countries. The aim of this study was to assess the
1-year prevalence of migraine, probable migraine and tension-type headache (TTH) in the Croatian population. Methods: The design of the study was a cross-sectional survey of
an adult population sample using a self-completed questionnaire. Results: The 1-year crude prevalence of migraine
without and with aura in this study was 7.5%, of probable
migraine 11.3%, and of TTH 21.2%. The 1-year age- and sexadjusted prevalence of migraine was 6.2%, of probable migraine 8.8%, and of TTH 20.7%; the prevalence of migraine
combined with probable migraine was 15.0%. Total crude
prevalence of headache (combination of migraine, probable
migraine and TTH) was 39.9%. Prevalence of migraine was
higher in continental than in Mediterranean areas of Croatia.
Multivariate regression analysis showed that the highest risk
of suffering from any kind of headache is observed for the

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following people: living in Dubrovnik, being female, having

elementary or high school education, being married, employed and living in an urban or suburban area. Conclusion:
The prevalence of migraine and probable migraine is similar
as in other Western countries. Certain demographic characteristics differ among patients with and without headache.
Copyright 2010 S. Karger AG, Basel

Introduction

Population-based epidemiological studies about headaches, especially migraine, have been carried out in many
countries. The 1-year prevalence of migraine has been
estimated to range from 3 to 24.6% and for tension-type
headache (TTH) from 21.7 to 86.5%, whereas the lifetime
prevalence of migraine has been estimated to range from
3.1 to 27.5% and for TTH from 12.9 to 78%, depending on
the study population and methods of assessment [1, 2].
According to these studies, migraine is present in 629%
of women and 312% of men depending on the data
source [1].
The majority of epidemiological studies were undertaken before the second edition of the International ClasVlasta Vukovi, MD, PhD
Department of Neurology
University Hospital Sestre milosrdnice
Vinogradska c. 29, HR10 000 Zagreb (Croatia)
Tel. +385 1 3787 752, Fax +385 1 376 8282, E-Mail vlasta.vukovic@uclmail.net

sification of Headache Disorders (ICHD-2) [3] and assessed the prevalence of strict migraine. Since clinical
and epidemiological studies show that a proportion of the
studied population does not fulfill all criteria for migraine but clinically most likely have migraine, a subgroup of probable migraine was introduced. Some studies published before the ICHD-2 criteria have classified
migraine that does not fulfill all criteria for migraine as
border-line migraine [4, 5] and others as probable migraine which refers to the migraineur disorder in the
ICHD-1 (1.7) [68].
The only epidemiological population-based survey
carried out in Croatia was in 2001, and the study population consisted of all residents aged 1565 years of the city
Bakar [9].
The aim of this study was to assess the 1-year prevalence of migraine, probable migraine and TTH in the
Croatian population.
Methods
The design of the study was a cross-sectional survey of an adult
population sample using a self-completed questionnaire. The survey was conducted from March to October 2006 in 4 Croatian cities: Zagreb, Split, Osijek and Dubrovnik. The study population included adults 618 years of age. General practice registers provide
a convenient frame for sampling a local population [10]. In Croatia,
96% of the population are registered with a general practitioner
(GP), so the sample represents 4,437,000 Croatian adults [11]. Approximately 7002,000 patients are registered with 1 general practice. The questionnaires were distributed in general practices to get
a mix of urban, suburban and rural settings, and a spread of social
classes. The GPs (18 in total: 7 in Zagreb, 2 in Osijek, 4 in Dubrovnik and 5 in Split) were randomly selected by a computer from
a national list and then contacted by phone by our researchers. All
GPs who were contacted agreed to participate in this study. The
GPs selected patients randomly from their computer database; we
did not apply any formal (computerized) method of randomization: the GPs were asked to choose a list of any 110120 patients
from their database. The nurse then contacted the patients by
phone, explained the purpose of the study and if the patient gave
consent to participate in the survey (fill out the questionnaire), the
questionnaire was sent by mail. Gender distribution was approximately the same at the beginning of the study (questionnaires were
sent to 2,070 inhabitants: 50% men and 50% women).
The questionnaire comprised 3 sections. Section 1 consisted
of questions regarding demographic data (age, gender, education,
marital status, employment and place of living). Section 2 consisted of questions regarding the presence of headache, such as: (a)
Do you suffer from headaches? (b) Do you suffer from migraine?
The patients have been instructed to respond to section 2 with
no if they had not suffered from headaches within the past year,
or had no more than 1 mild headache attack not requiring treatment. If the respondents answered yes to section 2, they were
asked to complete the rest of the questionnaire (section 3). Section

60

Neuroepidemiology 2010;35:5965

3 included questions that aimed to define the nature of the headache according to the ICHD-2 criteria for migraine and TTH [3].
The algorithm classified headache sufferers into three groups: (a)
migraine fulfilling ICHD-2 criteria for migraine without or
with aura (ICHD-2 1.1 and 1.2); (b) probable migraine respondents were categorized as having probable migraine if they fulfilled all but 1 criteria for migraine (ICHD-2 1.6); (c) TTH fulfilling the criteria for TTH (ICHD-2).
Patients who had migraine and TTH were classified into the
group of migraine.
The questionnaire was designed using a combination of similar studies, the ICHD-2 criteria and advice from epidemiologic
researchers. The respondents were asked to tick one or more offered answers to the questions regarding the description of their
headaches in terms of pain location, headache frequency, character of pain, duration of pain, pain intensity, associated symptoms
and the presence of aura symptoms.
On return, the questionnaires were checked for completeness
and questionnaires containing more than 1 unanswered question
from any of the 3 sections were excluded from the final analysis.
The diagnosis of migraine, probable migraine and TTH was
assessed by 2 authors (V.V. and D.J.) and the 1-year prevalence
(crude and age- and sex-adjusted) was calculated. Demographic
characteristics of patients with and without headache were analyzed as well as of the patients with headaches according to headache subtype. The study had been approved by the committee for
research ethics.
Statistical Analysis
Data analysis was performed using the Statistica for Windows
release 6.0. Continuous variables were summarized as mean and
standard deviation. Categorical variables were summarized as
number and percentage. In the statistical analysis, the 2 test was
used to compare the distribution of categorical variables between
subgroups and the Student t test to compare continuous variables.
The gender- and age-adjusted prevalence was also calculated.
Univariate and multivariate logistic regression analysis was used
to identify the odds ratios (ORs) with 95% confidence intervals
(CIs) for having a headache, and its subtypes according to demographic characteristics of the population in question. Statistical
significance was considered at p ! 0.05.

Results

The starting sample included 2,000 questionnaires,

with 1,542 of them being suitable for analysis (77.1%); the
rest of the questionnaires were not included due to missing data or refusal to participate in the study. Of the total
1,542 responders, 616 (39.9%) validly indicated that they
suffered from headache.
Demographic Characteristics of All Respondents
Demographic characteristics of patients with and
without headache are shown in table1. The mean age of
respondents in both groups was 42 years (standard deviation, 17). The majority of the respondents had high
Vukovi /Plavec /Pavelin /Januljak /
Ivankovi /Demarin

school education, were married, were employed and resided in a city.

Prevalence of Migraine, Probable Migraine and TTH
Among participants with headache, 115 (18.7%) suffered from migraine, 174 (28.2%) from probable migraine
with or without TTH and 327 (53.1%) from TTH only.
The 1-year crude prevalence of migraine (without and
with aura) in this study was 7.5% (women 9.5%, men
4.6%), of probable migraine 11.3% (women 14.9%, men
6.1%) and of TTH 21.2% (women 23.2%, men 19.1%). The
1-year age- and sex-adjusted prevalence of migraine was
6.2% (women 8.3%, men 4.0%), of probable migraine
8.8% (women 12.3%, men 5.0%) and of TTH 20.7%
(women 23.8%, men 17.1%). Upon evaluation of all questionnaires suitable for analysis, women represented 60%
of the total sample; therefore, we calculated age- and sexadjusted prevalence. Age- and sex-adjusted prevalence of
combined migraine and probable migraine was 15.0%
(women 20.6%, men 9.0%). Crude prevalence of migraine
with aura was 3.0%. Total crude prevalence of headache
(combined migraine + probable migraine + TTH) was
39.9%. Age- and sex-adjusted and crude prevalence of migraine, probable migraine and TTH is shown in table2.
Demographic Characteristics of Respondents
according to Headache Subtypes
Demographic characteristics of patients with migraine, probable migraine and TTH are shown in table3.
Women were more likely to suffer from all types of
headache compared with men: ORage-adjusted, 2.17 (95%
CI, 1.353.41) for migraine; ORage-adjusted, 2.65 (95% CI,
1.764.00) for probable migraine, and ORage-adjusted, 1.51

Table 1. Demographic characteristics of patients with and without headache

Demographic
characteristic

City
Zagreb
Split
Dubrovnik
Osijek
Women
Age (mean8SD)
Education
Elementary
High school
College
University
NA
Marital status
Married
Not married
Widower
Divorced
NA
Employment
Employed
Not employed
Student
Retired
NA
Place of living
City
Suburb
Rural area
NA

Total
Headache
(n = 1,542) (n = 640)

No
headache
(n = 902)

p
value

<0.0001
333 (36.9)
285 (31.6)
150 (16.6)
57 (6.3)
474 (52.5) <0.0001
0.4533
42817
0.6754
183 (11.9) 78 (12.2) 105 (11.6)
827 (53.6) 350 (54.7) 477 (52.9)
49 (7.7)
84 (9.3)
133 (8.6)
150 (23.4) 204 (22.6)
354 (23)
43 (2.8)
0.0095
814 (52.8) 369 (57.7) 445 (49.3)
553 (35.9) 202 (31.6) 351 (38.9)
56 (3.6)
20 (3.1)
36 (4.0)
66 (4.3)
29 (4.5)
37 (4.1)
52 (3.4)
<0.0001
895 (58)
408 (63.8) 487 (54.0)
228 (14.8) 90 (14.1) 138 (15.3)
185 (12)
68 (10.6) 117 (13.0)
203 (13.2) 58 (9.1) 145 (16.1)
31 (2.0)
0.1024
402 (62.8) 585 (64.9)
987 (64)
414 (26.8) 189 (29.5) 225 (24.9)
120 (7.7)
43 (6.7)
76 (8.4)
21 (1.4)

578
485
307
95
926 (60.1)
42817

245 (38.3)
200 (31.3)
157 (24.5)
38 (5.9)
452 (70.6)
42814

Figures in parentheses are percentages. NA = Not answered.

Table 2. Prevalence of migraine, probable migraine and TTH

Prevalence
Crude
Women
Men
Age-adjusted
Women
Men
Total, %
Crude
Age-adjusted
Age- and sex-adjusted

Migraine
(n = 115)

Probable migraine Migraine + probable TTH

(n = 174)
migraine (n = 289) (n = 327)

Total (migraine + probable

migraine + TTH) (n = 616)

88 (9.5)
27 (4.6)

138 (14.9)
36 (6.1)

226 (24.4)
63 (10.7)

215 (23.2)
112 (19.1)

441 (47.6)
175 (28.4)

76.8 (8.3)
24.6 (4.0)

113.7 (12.3)
31.1 (5.0)

190.5 (20.6)
55.7 (9.0)

220.8 (23.8)
105.5 (17.1)

411.3 (44.4)
161.2 (26.1)

7.5
6.7
6.2

11.3
9.4
8.8

18.7
16.0
15.0

21.2
21.2
20.7

39.9
37.1
35.7

Figures in parentheses are percentages.

Prevalence of Primary Headaches in

Croatia

Neuroepidemiology 2010;35:5965

61

Table 3. Demographic characteristics of patients according to

headache subtype
Demographic
characteristic
City
Zagreb
Split
Dubrovnik
Osijek
Women
Age (mean8SD)
Education
Elementary
High school
College
University
NA
Marital status
Married
Not married
Widower
Divorced
NA
Employment
Employed
Not employed
Student
Retired
NA
Place of living
City
Suburb
Rural area
NA

Probable
migraine
(n = 174)

p
value

Migraine
(n = 115)

TTH
(n = 327)

50 (43.5)
28 (24.4)
25 (21.7)
12 (10.4)
88 (77.9)
43814

85 (26.0) 99 (56.9) <0.0001

102 (31.2) 61 (35.1)
122 (37.3)
7 (4.0)
18 (5.5)
7 (4.0)
215 (66.6) 138 (82.1) 0.0042
0.1814
42814
40814

13 (11.5)
58 (51.3)
10 (8.9)
32 (28.3)
2 (1.7)

40 (12.4)
197 (60.8)
28 (8.6)
59 (18.2)

18 (10.8)
85 (50.9)
9 (5.4)
55 (32.9)

0.0529

65 (59.1)
35 (31.8)
5 (4.6)
4 (3.6)
6 (5.2)

198 (62.1)
94 (29.5)
10 (3.1)
17 (5.3)

95 (55.6)
65 (38.0)
4 (2.3)
7 (4.1)

0.3034

76 (67.9)
14 (12.5)
9 (8.0)
13 (11.6)
3 (2.6)

209 (65.5) 108 (63.5)

53 (16.6) 20 (11.8)
29 (17.1)
28 (8.8)
13 (7.7)
29 (9.1)

72 (63.7)
35 (31.0)
6 (5.3)
2 (1.7)

179 (55.1) 136 (78.2) <0.0001

122 (37.5) 27 (15.5)
11 (6.3)
24 (7.4)

0.07303

Figures in parentheses are percentage. NA = Not answered.

(95% CI, 1.171.95) for TTH (table2). In our study, women had an ORage-adjusted of 2.26 (95% CI, 1.812.82) for any
headache type compared with men (p = 0.0042; table3).
The level of education in our study was not significantly different among respondents with or without
headache (p = 0.675). However, analysis of headache subgroups showed that more educated participants suffered
from migraine or probable migraine than from TTH
alone, while respondents who have elementary or high
school education more frequently suffered from TTH
(p= 0.053; table3).
Married (45.3%) and divorced (43.9%) respondents were
more likely to suffer from headaches than single (36.5%) or
widowed (35.7%) respondents (p = 0.0095; table1).
62

Neuroepidemiology 2010;35:5965

Employed participants were more likely to suffer from

headaches (45.6%) than unemployed (39.4%), students
(36.7%) or retired (28.6%) respondents (p ! 0.0001; table1). The prevalence of migraine or TTH was not significantly different among respondents with different
types of headache in regard to marital status (p = 0.3) or
employment status (p = 0.07) (table3).
Place of residence was not associated with the prevalence of headaches (p = 0.1024; table1). According to headache subtypes, respondents residing in cities were more
likely to suffer from migraine and probable migraine than
from TTH, while respondents from rural areas were more
likely to suffer from TTH (p ! 0.0001; table3).
The prevalence of migraine was higher in continental
cities (Zagreb and Osijek), whereas the prevalence of
TTH was higher in Mediterranean cities (Split and Dubrovnik) (p ! 0.0001; table4). People residing in Zagreb
and Osijek had around 80% higher odds to suffer from
migraine than people living in Split (ORs, 1.78 and 1.82).
Multivariate logistic regression analysis of all patients
with headaches showed that most likely to suffer from
headaches were people residing in the city of Dubrovnik
(OR, 1.64; 95% CI, 1.102.46; p = 0.0163), women (OR, 2.14;
95% CI, 1.692.70; p ! 0.0001), those who were married
(OR, 1.69; 95% CI, 1.262.27; p = 0.0005), with elementary
or high school education (OR, 1.14; 95% CI, 1.011.28; p =
0.0456), people residing in urban or suburban areas (OR,
1.69; 95% CI, 1.053.45; p = 0.0322) and employed participants (OR, 1.64; 95% CI, 1.142.38; p = 0.008).
Multivariate logistic regression analysis of patients according to headache subtype showed that more likely to
suffer from migraine or probable migraine were people
residing in the city of Zagreb (OR compared to Dubrovnik, 4.72; 95% CI, 3.107.21; p ! 0.0001) and women
(OR, 1.95; 95% CI, 1.322.89; p = 0.0008). Age- and sexadjusted prevalence analysis showed that the prevalence
of migraine and probable migraine was higher in continental than Mediterranean areas (OR for Zagreb vs. Split
for migraine, 1.82; OR for Zagreb vs. Dubrovnik for migraine + probable migraine, 3.47; p ! 0.0001 for both) and
vice versa for TTH (OR for Dubrovnik vs. Zagreb, 4.2;
p!0.0001) (table4).
Discussion

The 1-year crude prevalence of primary headaches

(migraine + probable migraine + TTH) in Croatia is
39.9%; the range in Europe and North America is between 13.4 and 87.3% [1].
Vukovi /Plavec /Pavelin /Januljak /
Ivankovi /Demarin

Table 4. Crude and age- and sex-adjusted prevalence of subtypes of headache with ORs according to the geographic region (Zagreb
and Osijek are in the continental part; Split and Dubrovnik are in the Mediterranean part of Croatia)

Demographic characteristic

Crude
Zagreb (n = 578)
Split (n = 485)
Dubrovnik (n = 307)
Osijek (n = 95)
Age- and sex-adjusted
Zagreb (n = 578)
Split (n = 485)
Dubrovnik (n = 307)
Osijek (n = 95)

Migraine + probable migraine (n = 289)

TTH (n = 327)

cases
(prevalence, %)

cases
(prevalence, %)

OR
(95% CIs)

OR
(95% CIs)

149 (25.8)
89 (18.4)
32 (10.4)
19 (20.0)

2.98 (1.994.55)
1.93 (1.263.01)
1.00 reference
2.14 (1.133.99)

85 (14.7)
102 (21.0)
122 (39.7)
18 (18.9)

1.00 reference
1.54 (1.122.12)
3.82 (2.765.29)
1.36 (0.762.35)

133.9 (23.2)
72.4 (14.9)
25.4 (8.3)
14.5 (15.3)

3.34 (2.175.35)
1.95 (1.223.18)
1.00 reference
2.00 (1.054.20)

83.5 (14.4)
97.7 (20.1)
129.9 (42.3)
15.2 (16.0)

1.00 reference
1.49 (1.082.05)
4.34 (3.135.97)
1.13 (0.612.01)

TTH is the most common form of headache; however,

less epidemiologic surveys have been conducted for TTH
than for migraine [1]. The 1-year age- and sex-adjusted
prevalence of TTH in our study was 20.7%, which is in
accordance with other studies worldwide (range, 19.6
86.5%) [1, 1218]. Some studies have shown higher prevalence of TTH in women (as in our study) while others
reported no difference [1]. Cost analysis studies have
shown that the direct costs for TTH are even higher than
for migraine, primarily due to higher prevalence [19].
The prevalence of migraine depends on cultural specifics, genetic factors, eating habits, climate and methodology of data collection. Estimates of migraine prevalence in recent studies using the ICHD-2 were about
310% in men and 629% in women [4, 5, 12, 14, 2026].
A prevalence of 9% or less has been reported in Japan,
Singapore, Belgium, Hong Kong, China, Taiwan, Hungary, Saudi Arabia, Nigeria, Tanzania, Tunis and Ethiopia [1, 4, 13, 2735], and between 10 and 20% in Denmark,
France, Austria, most countries in Latin America, Turkey, USA, Canada, Spain, Italy, Sweden, Denmark and
Norway [12, 15, 17, 20, 21, 2325, 3639]. A prevalence of
21% and higher has been reported in Germany, Brazil and
Korea [16, 40, 41].
Our study assessed the prevalence of strict and probable migraine as well as the prevalence of TTH in 4 different cities in Croatia. The 1-year age- and sex-adjusted
prevalence of migraine in our study was 6.2%, of probable
migraine 8.8% and of combined migraine and probable
migraine 15.0%. The reason for a relatively high prevalence of migraine in our study may partially be due to the
inclusion of probable migraine. The prevalence of strict

migraine and probable migraine in our study was higher

in women than in men, which is consistent with other
studies worldwide [4, 16, 2022, 36, 42]. The prevalence
of migraine with aura in our study was 2.5%, which was
similar to other studies [17, 20, 30, 42].
The prevalence differs between countries, even within
the same country, which mostly depends on the method
of data collection and the way the ICHD criteria are applied. The majority of migraine epidemiologic studies in
recent years have used the ICHD-1 criteria from 1988 (1st
edition) [43], and a few have applied the ICHD-2 criteria
from 2004 (2nd edition). The ICHD-2 criteria define 6
subtypes of migraine. Most epidemiologic studies have
included only the 2 most common forms: migraine with
or without aura (ICHD-2 1.1 and 1.2). However, clinical
and population-based studies have shown that a large
number of patients with headaches fail to fully meet the
ICHD-2 criteria for migraine and although having migrainous features, these patients should be classified as
having probable migraine (ICHD-2 1.6). The prevalence
of probable migraine in the general population is still
poorly understood. In our study, the prevalence of probable migraine was 8.8%. Prior studies estimated the prevalence of probable migraine to be between 2.3 and 14.6%
[48, 17, 23, 42, 44, 45]. A study from France showed that
the prevalence of strict migraine was 8.1%; when borderline migraine was included, the total prevalence was
12.1% (ICHD-1 criteria) [5]. Another study from France
using ICHD-2 criteria showed that the prevalence of
strict migraine was 11.2%, of probable migraine 10.1%,
and total migraine prevalence was 21.3% [23]. The highest lifetime prevalence was found in Brazil (22.1% for mi-

Prevalence of Primary Headaches in

Croatia

Neuroepidemiology 2010;35:5965

63

graine and 40.3% for migraine and probable migraine)

[16]. Studies from the USA reported a lifetime prevalence
of 11.3% (other headaches without aura) and a 1-year
prevalence of probable migraine of 4.5% [42, 45]. Oneyear prevalence of strict migraine in Sweden was 13.2%,
and when patients with a headache duration of !4 h and
172 h were included the prevalence was 17% [21].
Evidence from other studies supports the view that
probable migraine might be the prevalent form of migraine. In that case, population studies focusing on strict
migraine (ICHD-2 1.1 and 1.2) may underestimate the
significance and impact of migraine. Furthermore, probable migraine is associated with a substantial disability
measured by a decrement in health-related quality of life
and Migraine Disability Assessment score [44]. Therefore, diagnosis of probable migraine in clinical practice is
an important issue.
Croatia can geographically be divided into a continental and Mediterranean part; therefore, we assessed the
prevalence of headache subtypes according to geographical belonging. Interestingly, the prevalence of migraine
was higher in continental cities (Zagreb and Osijek),
whereas the prevalence of TTH was higher in Mediterranean cities (Split and Dubrovnik). Literature research
revealed that no prevalence study compared such data.
We can speculate that the lifestyle of people living in the
Mediterranean area is different than in the continental
area (food and drinking habits, weather changes).
Some studies have shown a higher prevalence of migraine among people with a high education level [4648],
while others have not [20, 21, 30, 42, 49]. The level of education in our study was not significantly different in
groups with and without headache. However, highly educated participants suffered from migraine or probable
migraine more than TTH alone, while respondents with
elementary or high school education more frequently suffered from TTH.
Most epidemiological studies have not shown a correlation between marital status and migraine [12, 16, 47]. In
our study, married and divorced respondents were more
likely to suffer from headaches than single or widowed
participants. Our study showed that employed participants were more likely to suffer from headaches than unemployed, students or retired respondents. Furthermore,
the prevalence of migraine or TTH did not significantly
differ with regard to the employment or marital status.
Higher migraine prevalence among urban areas has been
shown in two studies [46, 47]. In our study, the place of
residence was not associated with the prevalence of headaches. According to headache subtypes, respondents liv64

Neuroepidemiology 2010;35:5965

ing in cities were more likely to suffer from migraine and

probable migraine than from TTH, while respondents
from rural areas were more likely to suffer from TTH.
Multivariate regression analysis showed that the highest
likelihood for any kind of headache had people living in
Dubrovnik, female, with elementary or high school education, married, employed and living in urban or suburban area. Lower risks had men, with a high level of education, living in rural areas, and retired.
A shortcoming of this study might be the possibility
that some individuals classified as having migraine or
probable migraine in the current study would not meet
criteria if assessed clinically since the headache groups
were defined using a self-completed questionnaire that
was based on ICHD-2 criteria and not by clinical assessment, therefore classification errors are possible. Another
limitation was that this study was performed as a crosssectional and not a longitudinal study.
The prevalence of patients with probable migraine is
shown to be relatively high in Croatia; it is possible that
in clinical practice a number of these patients are not recognized and therefore not treated as such. We hope that
the results of this study will add on to the results of similar epidemiological studies worldwide, and point to
the importance of recognition not only of migraine, but
probable migraine as well.

Acknowledgement
This study was supported in part by a grant from GSK.

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