Materiały źródłowe

• #1 Diagnosing Headache | NYU Langone Health

  https://nyulangone.org/conditions/headache/diagnosis

  For many people, headaches are merely an occasional nuisance. But for some, headaches may have a profound impact on their lives. If your headaches become severe, NYU Langone doctors can provide you with the best and most effective treatment plan. Our experts, including neurologists specially trained in headache medicine, work together with specialists such as otolaryngologists, endocrinologists, neuro-ophthalmologists, internists, gynecologists, pain medicine doctors, physical medicine specialists, psychologists, psychiatrists, neuroradiologists, and neurosurgeons to identify and alleviate sources of pain and to develop an interdisciplinary treatment plan. Headaches are divided into two categories: primary and secondary. Primary headaches are not caused by an underlying health condition or structural problems in the brain, head, or neck.

• #2 Headache: What It Is, Types, Causes, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/9639-headaches

  Headaches are a very common condition that most people will experience many times during their lives. While most headaches aren’t dangerous, certain types can be a sign of a serious underlying condition. […] There are more than 150 types of headaches. They fall into two main categories: primary and secondary headaches. […] An underlying medical condition causes secondary headaches. They’re considered a symptom or sign of a condition. […] If you have headaches often or if they’re very severe, reach out to your healthcare provider. […] It’s important to diagnose headaches correctly so your provider can prescribe specific therapy to help you feel better. […] After evaluating the results of your headache history, physical examination and neurological examination, your physician should be able to determine what type of headache you have, whether or not a serious problem is present and whether additional tests are needed.

• #3 The International Classification of Headache Disorders – ICHD-3

  https://ichd-3.org/

  Primary headaches are disorders by themselves. They are caused by independent pathomechanisms and not by other disorders. Examples are migraine, tension-type headache or cluster-headache […] Secondary headaches develop as a secondary symptom due to another disorder that is known to cause headache. Examples are headaches attributed to bacterial meningitis, to trauma or medication overuse headache.

• #4 Headache: What It Is, Types, Causes, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/9639-headaches

  Headaches are a very common condition that most people will experience many times during their lives. While most headaches aren’t dangerous, certain types can be a sign of a serious underlying condition. […] There are more than 150 types of headaches. They fall into two main categories: primary and secondary headaches. […] An underlying medical condition causes secondary headaches. They’re considered a symptom or sign of a condition. […] If you have headaches often or if they’re very severe, reach out to your healthcare provider. […] It’s important to diagnose headaches correctly so your provider can prescribe specific therapy to help you feel better. […] After evaluating the results of your headache history, physical examination and neurological examination, your physician should be able to determine what type of headache you have, whether or not a serious problem is present and whether additional tests are needed.

• #5 Diagnosing Headache | NYU Langone Health

  https://nyulangone.org/conditions/headache/diagnosis

  For many people, headaches are merely an occasional nuisance. But for some, headaches may have a profound impact on their lives. If your headaches become severe, NYU Langone doctors can provide you with the best and most effective treatment plan. Our experts, including neurologists specially trained in headache medicine, work together with specialists such as otolaryngologists, endocrinologists, neuro-ophthalmologists, internists, gynecologists, pain medicine doctors, physical medicine specialists, psychologists, psychiatrists, neuroradiologists, and neurosurgeons to identify and alleviate sources of pain and to develop an interdisciplinary treatment plan. Headaches are divided into two categories: primary and secondary. Primary headaches are not caused by an underlying health condition or structural problems in the brain, head, or neck.

• #6 The International Classification of Headache Disorders – ICHD-3

  https://ichd-3.org/

  Primary headaches are disorders by themselves. They are caused by independent pathomechanisms and not by other disorders. Examples are migraine, tension-type headache or cluster-headache […] Secondary headaches develop as a secondary symptom due to another disorder that is known to cause headache. Examples are headaches attributed to bacterial meningitis, to trauma or medication overuse headache.

• #7 Headaches | Migraines – Causes, Diagnostic Tests and Treatment

  https://www.radiologyinfo.org/en/info/headache

  A headache is pain in the head or upper neck. They may be primary (not associated with a medical condition) or secondary (caused by an injury or medical condition). […] Your doctor may order head MRI, head CT or lumbar puncture to help diagnose and evaluate your condition. […] To diagnose the cause of headaches and to rule out underlying medical conditions, physicians obtain a patient history and conduct a careful neurological examination. Diagnostic testing may include the following imaging tests: […] Physicians use CT of the brain to detect bleeding caused by a ruptured or leaking aneurysm, stroke, brain tumors and diseases or malformations of the skull. […] Physicians use MRI of the brain to examine the anatomy of the brain and to assist in the diagnosis of tumors, developmental abnormalities, blood vessel problems (such as an aneurysm), disorders of the eyes and the inner ear, stroke, disease involving the pituitary gland and certain chronic disorders of the nervous system, such as multiple sclerosis.

• #8 Headache: What It Is, Types, Causes, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/9639-headaches

  Headaches are a very common condition that most people will experience many times during their lives. While most headaches aren’t dangerous, certain types can be a sign of a serious underlying condition. […] There are more than 150 types of headaches. They fall into two main categories: primary and secondary headaches. […] An underlying medical condition causes secondary headaches. They’re considered a symptom or sign of a condition. […] If you have headaches often or if they’re very severe, reach out to your healthcare provider. […] It’s important to diagnose headaches correctly so your provider can prescribe specific therapy to help you feel better. […] After evaluating the results of your headache history, physical examination and neurological examination, your physician should be able to determine what type of headache you have, whether or not a serious problem is present and whether additional tests are needed.

• #9 Migraine Headache Differential Diagnoses

  https://emedicine.medscape.com/article/1142556-differential

  When headache is episodic and recurrent and follows a well-established pattern, the patient likely has a primary headache disorder (ie, headaches with no organic or structural etiology). Differentiating migraine from other primary headaches (eg, muscle contraction tension headache, cluster headache) is important, as optimal treatment may differ. […] Migraine may also may simulate or be simulated by secondary headache disorders or coexist with a secondary headache disorder. Any of the following features suggest a secondary headache disorder and warrant further investigation: The first or worst headache of the patient’s life, especially if rapid in onset. A change in frequency, severity, or clinical features of the attack. New progressive headache that persists for days. Precipitation of headache with Valsalva maneuvers (ie, coughing, sneezing, bearing down). The presence of associated neurologic signs or symptoms (eg, diplopia, loss of sensation, weakness, ataxia). Onset of headaches after the age of 55 years. Headache developing after head injury or major trauma. Persistent, 1-sided throbbing headaches. Headache accompanied by stiff neck or fever. Atypical history or unusual character that does not fulfill the criteria for migraine. Inadequate response to optimal therapy.

• #10

  https://www.who.int/news-room/fact-sheets/detail/headache-disorders

  Headache disorders are among the most common disorders of the nervous system. […] Worldwide, only a minority of people with headache disorders are appropriately diagnosed and treated by a health care provider. […] Many of those troubled by headaches do not receive effective diagnosis and care. Appropriate treatment of headache disorders requires training of health professionals, accurate diagnosis and recognition of the conditions, appropriate treatment with cost-effective medications, simple lifestyle modifications and patient education. […] Lack of knowledge among health care providers is the principal clinical barrier. Many people with headache disorders are not diagnosed and treated.

• #11 Status of diagnosis and preventative treatment for primary headache disorders: real-world data of unmet needs in China | The Journal of Headache and Pain | Full Text

  https://thejournalofheadacheandpain.biomedcentral.com/articles/10.1186/s10194-023-01654-6

  Headache disorders are widely prevalent and pose a considerable economic burden on individuals and society. […] Globally, misdiagnosis and inadequate treatment of primary headache disorders remain significant challenges, impeding the effective management of such conditions. […] Despite advancements in headache management over the last decade, a need for comprehensive evaluations of the status of primary headache disorders in China regarding diagnosis and preventative treatments persists. […] Over half of the individuals with primary headache disorders (56.6%, 1,624/2,868) remained undiagnosed. […] The previously correct diagnosis rates for migraine, TTH, TACs, and MOH were 27.3% (580/2,124), 8.1% (54/668), 23.2% (13/56), and 3.5% (8/231), respectively. […] While there has been progress made in the rate of correct diagnosis of primary headache disorders in China compared to a decade ago, the prevalence of misdiagnosis and inadequate treatment of primary headaches remains a veritable issue.

• #12 Diagnosing Headache | NYU Langone Health

  https://nyulangone.org/conditions/headache/diagnosis

  Secondary headaches are more rare and are caused by an injury or other medical conditions such as an infection, tumor, stroke, or aneurysm. […] To determine the type of headache causing your pain, neurologists at NYU Langone ask about your headache history and symptoms, focusing on the frequency, intensity, duration, location, and any known triggers. Your doctor also conducts a comprehensive review of your medical history and family history of headache and performs a physical exam to obtain a complete picture of your health. […] Relying on over-the-counter pain medication to treat chronic headaches can lead to overuse of these medications, which, over time, can make headaches worse and unresponsive to treatment, even when the medications are used as directed. […] Depending on your symptoms and the results of your medical and neurologic examinations, your physician may recommend further diagnostic testing. Your doctor may use one or more of the following tests to arrive at the most accurate diagnosis.

• #13 Headaches – Types, Causes, Symptoms, Diagnosis, Treatment

  https://www.webmd.com/migraines-headaches/migraines-headaches-basics

  Headache Diagnosis […] Once you get your headaches diagnosed correctly, you can start the right treatment plan for your symptoms. […] The first step is to talk to your doctor about your headaches. Theyll give you a physical exam and ask about your symptoms and how often they happen. Its important to be as detailed as possible with these descriptions. Give your doctor a list of things that cause your headaches, things that make them worse, and what helps you feel better. You can track details in a headache diary to help your doctor diagnose your problem. […] Most people dont need special diagnostic tests. But sometimes, doctors suggest a CT scan or MRI to look for problems inside your brain that might cause your headaches. Skull X-rays wont help. An electroencephalogram (EEG) is also unnecessary unless youve passed out when you had a headache. […] If your headache symptoms get worse or happen more often despite treatment, ask your doctor to refer you to a headache specialist.

• #14

  https://www.healio.com/clinical-guidance/headaches/diagnosis-presentation-and-diagnosis

  Obtaining a complete headache history is the most vital tool in the diagnosis and management of a patient with headache. Items that should be included in the headache history to simplify this process include: […] It is important to determine if the patient is experiencing more than one type of headache. […] Determining the age at onset of the headaches may provide a significant clue to the type of headache the patient is experiencing. […] The frequency of headache attacks not only provides a clue to the diagnosis but also impacts the choice of treatment. […] Migraine is typically a one-sided headache, although it may occur bilaterally and may switch sides. […] An acute migraine attack usually continues for 4 to 24 hours. […] The pain of migraine is severe, may be incapacitating, and is described as throbbing or pulsating.

• #15 Diagnosis – The Migraine TrustVisualV1 – SearchVisualV1 – CrossVisualV1 – Home VisualV1 – CrossVisualV1 – Arrow

  https://migrainetrust.org/live-with-migraine/healthcare/diagnosis/

  Getting your migraine diagnosed […] If you are getting regular headaches or other symptoms that you suspect could be migraine, it is important to see a doctor and get a proper diagnosis. […] Diagnosis will therefore depend upon your doctor taking your medical history and ruling out other causes for the attacks. […] To make a firm diagnosis, information from two approaches will be used. […] A detailed history of the headaches and/or other symptoms will be taken. […] A thorough examination will be carried out, including a necessary neurological assessment. […] When you visit your doctor to talk about your headaches, you should therefore expect to give quite detailed information about your attacks. […] A change in the pattern of your headaches or other symptoms might be the result of the naturally changing course of migraine. […] However, any change in the pattern of your headaches should be checked with your doctor. […] If you suspect that you are experiencing more than one type of headache disorder or are not sure, see your doctor.

• #16 Acute Headache in Adults: A Diagnostic Approach | AAFP

  https://www.aafp.org/pubs/afp/issues/2022/0900/acute-headache-adults.html

  A detailed history and physical examination can distinguish between key features of a benign primary headache and concerning symptoms that warrant further evaluation for a secondary headache. Most headaches that are diagnosed in the primary care setting are benign. […] Evaluating acute headaches using a systematic framework such as the SNNOOP10 mnemonic can help detect life-threatening secondary causes of headaches. Red flag signs or symptoms such as acute thunderclap headache, fever, meningeal irritation on physical examination, papilledema with focal neurologic signs, impaired consciousness, and concern for acute glaucoma warrant immediate evaluation. […] For less urgent cases, magnetic resonance imaging of the brain is preferred for evaluating headaches with concerning features. Primary headache disorders without red flags or abnormal examination findings do not need neuroimaging.

• #17 Acute Headache – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK554510/

  Very often, in patients with headaches, the diagnosis can be established by careful history taking and physical examination. Primary headaches are not life-threatening and do not require imaging in the emergency department. […] Though less common, more serious etiologies of secondary headache must be considered before establishing a primary headache diagnosis. […] History should be geared toward obtaining a detailed account of the current headache, a full review of systems, and a description of any prior headache disorder or headache history. […] A thorough physical examination is important in all patients presenting with headaches. […] History and physical are usually sufficient to diagnose primary headaches, provided no high-risk features are present. For primary headaches, physicians must be able to differentiate the type of primary headache to initiate proper therapy.

• #18

  https://www.healio.com/clinical-guidance/headaches/diagnosis-presentation-and-diagnosis

  Clinicians must inventory the medications the patient is currently using. […] A thorough physical and neurologic examination is essential to rule out organic pathology for headache as well as to determine which diagnostic tests are required. […] Diagnostic testing may be required to rule out secondary causes of headache and to establish a baseline of some parameters. […] If the physician is not confident of the diagnosis, or if certain aspects of the history suggest possible organic causes of the headache, neuroimaging should be considered. […] This invasive procedure should only be undertaken if the symptoms warrant. […] The EEG is not used extensively because of the availability and efficiency of other tests. […] Obtaining baseline values for blood chemistries, complete blood count (CBC), and urinalysis will assist the physician in continuing therapy in patients with headache.

• #19 Tension headache – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/tension-headache/diagnosis-treatment/drc-20353982

  If you have regular headaches, your health care professional may give you a physical and a neurological exam. Your care professional works to pinpoint the type and cause of your headaches using these approaches. […] Your doctor can learn a lot about your headaches from the information you provide about the pain. […] Your health care professional may prescribe medicines that help you have fewer headaches or headaches that are less painful. Preventive medicines may help if you have regular headaches that aren’t relieved by pain medicine and other therapies. […] Your health care professional monitors your treatment to see how the preventive medicine is working. In the meantime, overusing pain relievers may interfere with the effects of the preventive medicines. Ask your health care professional about how often to use pain relievers while you’re taking preventive medicine.

• #20

  https://www.saem.org/about-saem/academies-interest-groups-affiliates2/cdem/for-students/online-education/m4-curriculum/group-m4-approach-to/headache

  35 yo female with a past medical history of hypertension presents with two hours of headache that was gradual in onset but is now 10/10. Reports a sharp pulsating pain in the front portion of her head. […] Headache is a common Emergency Department complaint. The causes of headache can range from benign to life threatening and these patients can deteriorate quickly, which makes thorough evaluation of these patients critical. […] A thorough neurological exam is essential for all patients with headache. Include testing of motor and sensory function, cranial nerves, reflexes, pronator drift, rapid alternating movements, finger-to-nose and heel-to-shin testing, Rhomberg test, gait assessment and mini mental status evaluation. […] When assessing patients with headache, it is important to consider both the most common etiologies of headache, as well as the life-threatening etiologies of headache. Broadly, headaches can be classified into two general categories; primary and secondary.

• #21 The differential diagnosis of chronic daily headaches: an algorithm-based approach | The Journal of Headache and Pain | Full Text

  https://thejournalofheadacheandpain.biomedcentral.com/articles/10.1007/s10194-007-0418-3

  Chronic daily headaches (CDHs) refers to primary headaches that happen on at least 15 days per month, for 4 or more hours per day, for at least three consecutive months. […] The differential diagnosis of CDHs is challenging and should proceed in an orderly fashion. […] The clinical approach to diagnosing CDH is the scope of this review. […] An important first step in headache diagnosis is to distinguish primary from secondary CDH. […] Once secondary headache is excluded by history, physical and neurological examination and/or appropriate testing, the next step is to diagnose the primary headache disorder. […] In the absence of secondary CDH, the clinician proceeds to diagnose a primary CDH disorder. […] If the headache is atypical or difficult to classify, the possibility of secondary headache should be reconsidered, although the modifying effect of any treatment being taken should be kept in mind.

• #22 Acute Headache – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK554510/

  Conversely, if patients have high-risk features or a history and physical not compatible with primary headache, the etiology of secondary headache must be investigated. […] When permitted, evaluation of headaches in the emergency department should begin with a thorough history and physical exam. Most headaches can be attributed to primary benign headache subtypes deduced through the primary survey; however, sometimes, further evaluation will be warranted. […] Routine laboratory testing is typically not helpful in headache diagnosis. However, if a life-threatening cause of headache is suspected, specific tests may be helpful. […] The 2019 ACEP clinical policy on headache recommends neuro-imaging in patients with headaches and any new neurologic deficits, new and sudden-onset severe headaches, HIV-positive patients with a new type of headache, and patients greater than 50 with a new headache.

• #23 When to order laboratory tests for your patient with a headache | Medmastery

  https://www.medmastery.com/guides/headaches-clinical-guide/when-order-laboratory-tests-your-patient-headache?srsltid=AfmBOooAe-HJJcMaRdwE7Sa7XMiHHW9RsZ18IiuqeYETZpnvnPcww0wn

  Laboratory tests can help you identify the cause of your patient’s headaches. […] Laboratory tests for patients with headache may be helpful under certain circumstances. A complete blood count (CBC), thyroid function, and erythrocyte sedimentation rate (ESR) are basic tests that are helpful in evaluating some headache patients. […] ESR is used to assess for possible giant cell arteritis. Individuals over the age of 50 with new onset headache should have their ESR and / or C-reactive protein (CRP) levels checked to exclude temporal arteritis. […] Perform a lumbar puncture when infection or subarachnoid hemorrhage is suspected. […] In a patient with headache, lumbar puncture can be used to identify infection, subarachnoid hemorrhage and intracranial hypertension. […] An electroencephalogram, or EEG, is not considered useful in the evaluation of headache unless there are concomitant considerations present to consider epilepsy in the diagnosis, such as with atypical migraine aura or recurrent loss or clouding of consciousness.

• #24

  https://journals.lww.com/neur/fulltext/2021/69001/diagnosis_and_management_of_headaches_in_the.22.aspx

  The identification of red flags can aid in more targeted physical examinations and investigations, which will in turn provide further insights on headache etiology. […] Neuroimaging is the most widely used investigation in the ED for headache, with a preference for computed tomography (CT), due to its quick performance time, low cost, and availability in the emergency department. […] A urine pregnancy test should be done in women of child-bearing age to exclude pregnancy, as a positive pregnancy test will influence the choice of neuroimaging and headache treatment due to potential fetal risk. […] In cases of suspected giant cell arteritis (GCA), a positive test of erythrocyte sedimentation rate (ESR) 50 mm/h, platelet 300 and C-Reactive Protein (CRP) 20 are useful serology tests in the prediction of GCA.

• #25 Acute Headache in Adults: A Diagnostic Approach | AAFP

  https://www.aafp.org/pubs/afp/issues/2022/0900/acute-headache-adults.html

  A detailed history and physical examination can distinguish between key features of a benign primary headache and concerning symptoms that warrant further evaluation for a secondary headache. Most headaches that are diagnosed in the primary care setting are benign. […] Evaluating acute headaches using a systematic framework such as the SNNOOP10 mnemonic can help detect life-threatening secondary causes of headaches. Red flag signs or symptoms such as acute thunderclap headache, fever, meningeal irritation on physical examination, papilledema with focal neurologic signs, impaired consciousness, and concern for acute glaucoma warrant immediate evaluation. […] For less urgent cases, magnetic resonance imaging of the brain is preferred for evaluating headaches with concerning features. Primary headache disorders without red flags or abnormal examination findings do not need neuroimaging.

• #26 Patient education: Headache causes and diagnosis in adults (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/headache-causes-and-diagnosis-in-adults-beyond-the-basics/print

  HEADACHE DIAGNOSIS […] Health care providers typically use a person’s description of their headache, in combination with an examination, to determine the type of headache. Some people have more than one type of headache. […] Most people do not need X-rays or other imaging tests. A computed tomography (CT) scan (or magnetic resonance imaging [MRI]) may be recommended in some circumstances, for example, if symptoms are unusual, if there are any danger signs (see 'Headache danger signs’ above), or if there are any abnormalities seen during the examination. Other possible reasons for brain imaging include: […] A sudden change in the pattern of headaches […] Headaches that steadily worsen despite treatment […] Signs or symptoms that suggest that another medical condition may be causing symptoms

• #27 Acute Headache – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK554510/

  Conversely, if patients have high-risk features or a history and physical not compatible with primary headache, the etiology of secondary headache must be investigated. […] When permitted, evaluation of headaches in the emergency department should begin with a thorough history and physical exam. Most headaches can be attributed to primary benign headache subtypes deduced through the primary survey; however, sometimes, further evaluation will be warranted. […] Routine laboratory testing is typically not helpful in headache diagnosis. However, if a life-threatening cause of headache is suspected, specific tests may be helpful. […] The 2019 ACEP clinical policy on headache recommends neuro-imaging in patients with headaches and any new neurologic deficits, new and sudden-onset severe headaches, HIV-positive patients with a new type of headache, and patients greater than 50 with a new headache.

• #28 Headaches | Migraines – Causes, Diagnostic Tests and Treatment

  https://www.radiologyinfo.org/en/info/headache

  A headache is pain in the head or upper neck. They may be primary (not associated with a medical condition) or secondary (caused by an injury or medical condition). […] Your doctor may order head MRI, head CT or lumbar puncture to help diagnose and evaluate your condition. […] To diagnose the cause of headaches and to rule out underlying medical conditions, physicians obtain a patient history and conduct a careful neurological examination. Diagnostic testing may include the following imaging tests: […] Physicians use CT of the brain to detect bleeding caused by a ruptured or leaking aneurysm, stroke, brain tumors and diseases or malformations of the skull. […] Physicians use MRI of the brain to examine the anatomy of the brain and to assist in the diagnosis of tumors, developmental abnormalities, blood vessel problems (such as an aneurysm), disorders of the eyes and the inner ear, stroke, disease involving the pituitary gland and certain chronic disorders of the nervous system, such as multiple sclerosis.

• #29 Headaches | Migraines – Causes, Diagnostic Tests and Treatment

  https://www.radiologyinfo.org/en/info/headache

  A headache is pain in the head or upper neck. They may be primary (not associated with a medical condition) or secondary (caused by an injury or medical condition). […] Your doctor may order head MRI, head CT or lumbar puncture to help diagnose and evaluate your condition. […] To diagnose the cause of headaches and to rule out underlying medical conditions, physicians obtain a patient history and conduct a careful neurological examination. Diagnostic testing may include the following imaging tests: […] Physicians use CT of the brain to detect bleeding caused by a ruptured or leaking aneurysm, stroke, brain tumors and diseases or malformations of the skull. […] Physicians use MRI of the brain to examine the anatomy of the brain and to assist in the diagnosis of tumors, developmental abnormalities, blood vessel problems (such as an aneurysm), disorders of the eyes and the inner ear, stroke, disease involving the pituitary gland and certain chronic disorders of the nervous system, such as multiple sclerosis.

• #30

  https://journals.lww.com/neur/fulltext/2021/69001/diagnosis_and_management_of_headaches_in_the.22.aspx

  A diagnosis of primary headache can be made if the criteria set by the International Headache Society (IHS) are met. […] The patterns of acute recurrence with symptom-free intervals and chronic non-progressive headaches mostly occur in migraine, tension-type headache, cluster headaches, and the other episodic syndromes. […] A CT brain is indicated if the history and physical examination point to an underlying secondary cause of headache. It is quick and can diagnose intracranial bleeds and tumors, which will require emergent management. […] In the absence of other neurological symptoms and signs, a CT brain delays the initiation of treatment and affects the mortality rate in this group of patients. […] Following comprehensive evaluation and diagnostic tests to exclude secondary causes of headaches, providing timely and effective control of symptoms remains the goal of management.

• #31 Headaches | Migraines – Causes, Diagnostic Tests and Treatment

  https://www.radiologyinfo.org/en/info/headache

  A headache is pain in the head or upper neck. They may be primary (not associated with a medical condition) or secondary (caused by an injury or medical condition). […] Your doctor may order head MRI, head CT or lumbar puncture to help diagnose and evaluate your condition. […] To diagnose the cause of headaches and to rule out underlying medical conditions, physicians obtain a patient history and conduct a careful neurological examination. Diagnostic testing may include the following imaging tests: […] Physicians use CT of the brain to detect bleeding caused by a ruptured or leaking aneurysm, stroke, brain tumors and diseases or malformations of the skull. […] Physicians use MRI of the brain to examine the anatomy of the brain and to assist in the diagnosis of tumors, developmental abnormalities, blood vessel problems (such as an aneurysm), disorders of the eyes and the inner ear, stroke, disease involving the pituitary gland and certain chronic disorders of the nervous system, such as multiple sclerosis.

• #32 Acute Headache in Adults: A Diagnostic Approach | AAFP

  https://www.aafp.org/pubs/afp/issues/2022/0900/acute-headache-adults.html

  A detailed history and physical examination can distinguish between key features of a benign primary headache and concerning symptoms that warrant further evaluation for a secondary headache. Most headaches that are diagnosed in the primary care setting are benign. […] Evaluating acute headaches using a systematic framework such as the SNNOOP10 mnemonic can help detect life-threatening secondary causes of headaches. Red flag signs or symptoms such as acute thunderclap headache, fever, meningeal irritation on physical examination, papilledema with focal neurologic signs, impaired consciousness, and concern for acute glaucoma warrant immediate evaluation. […] For less urgent cases, magnetic resonance imaging of the brain is preferred for evaluating headaches with concerning features. Primary headache disorders without red flags or abnormal examination findings do not need neuroimaging.

• #33 Headaches | Migraines – Causes, Diagnostic Tests and Treatment

  https://www.radiologyinfo.org/en/info/headache

  A headache is pain in the head or upper neck. They may be primary (not associated with a medical condition) or secondary (caused by an injury or medical condition). […] Your doctor may order head MRI, head CT or lumbar puncture to help diagnose and evaluate your condition. […] To diagnose the cause of headaches and to rule out underlying medical conditions, physicians obtain a patient history and conduct a careful neurological examination. Diagnostic testing may include the following imaging tests: […] Physicians use CT of the brain to detect bleeding caused by a ruptured or leaking aneurysm, stroke, brain tumors and diseases or malformations of the skull. […] Physicians use MRI of the brain to examine the anatomy of the brain and to assist in the diagnosis of tumors, developmental abnormalities, blood vessel problems (such as an aneurysm), disorders of the eyes and the inner ear, stroke, disease involving the pituitary gland and certain chronic disorders of the nervous system, such as multiple sclerosis.

• #34 Headaches | Migraines – Causes, Diagnostic Tests and Treatment

  https://www.radiologyinfo.org/en/info/headache

  A headache is pain in the head or upper neck. They may be primary (not associated with a medical condition) or secondary (caused by an injury or medical condition). […] Your doctor may order head MRI, head CT or lumbar puncture to help diagnose and evaluate your condition. […] To diagnose the cause of headaches and to rule out underlying medical conditions, physicians obtain a patient history and conduct a careful neurological examination. Diagnostic testing may include the following imaging tests: […] Physicians use CT of the brain to detect bleeding caused by a ruptured or leaking aneurysm, stroke, brain tumors and diseases or malformations of the skull. […] Physicians use MRI of the brain to examine the anatomy of the brain and to assist in the diagnosis of tumors, developmental abnormalities, blood vessel problems (such as an aneurysm), disorders of the eyes and the inner ear, stroke, disease involving the pituitary gland and certain chronic disorders of the nervous system, such as multiple sclerosis.

• #35 Diagnosing Migraine | NYU Langone Health

  https://nyulangone.org/conditions/migraine/diagnosis

  A doctor may order an MRI scan to look for other conditions that can cause headaches, such as a tumor or abscess, which is a collection of pus that has formed in response to an infection. […] MRA scans allow your doctor to see if blood vessels are blocked by a clot or if there are any other factors that may be restricting or increasing blood flow and triggering headaches.

• #36 Acute Headache in Adults: A Diagnostic Approach | AAFP

  https://www.aafp.org/pubs/afp/issues/2022/0900/acute-headache-adults.html

  Patients with headache and red flags (acute thunderclap headache, fever with meningeal irritation on physical examination, papilledema with focal neurologic signs or impaired consciousness, concern for acute glaucoma) in their history or physical examination warrant further investigation for secondary causes of headache. […] Patients with stable primary headache disorders (i.e., no red flags and normal neurologic examination) do not need neuroimaging. […] Migraine headache is classically underdiagnosed. Patients for whom a diagnosis of migraine should be considered include those with recurring sinus headaches or recurrent severe headaches with a normal neurologic examination. […] Patients presenting with acute thunderclap headache should have a CT scan performed within 12 hours of onset. […] A lumbar puncture must follow a reassuring CT scan to sufficiently exclude subarachnoid hemorrhage. […] Neuroimaging and an additional evaluation may be necessary to exclude life-threatening causes of headaches when red flags are present.

• #37 Headaches | Migraines – Causes, Diagnostic Tests and Treatment

  https://www.radiologyinfo.org/en/info/headache

  Physicians use a lumbar puncture to help diagnose infections, including meningitis (infection of the membranes covering the brain) and encephalitis (infection of the brain itself), inflammatory conditions of the nervous system, including Guillain-Barre syndrome and multiple sclerosis, bleeding around the brain (subarachnoid hemorrhage), and cancers involving the brain and spinal cord. […] If your headache is the result of an underlying medical condition or injury, your physician will discuss treatment options with you.

• #38 Acute Headache in Adults: A Diagnostic Approach | AAFP

  https://www.aafp.org/pubs/afp/issues/2022/0900/acute-headache-adults.html

  Patients with headache and red flags (acute thunderclap headache, fever with meningeal irritation on physical examination, papilledema with focal neurologic signs or impaired consciousness, concern for acute glaucoma) in their history or physical examination warrant further investigation for secondary causes of headache. […] Patients with stable primary headache disorders (i.e., no red flags and normal neurologic examination) do not need neuroimaging. […] Migraine headache is classically underdiagnosed. Patients for whom a diagnosis of migraine should be considered include those with recurring sinus headaches or recurrent severe headaches with a normal neurologic examination. […] Patients presenting with acute thunderclap headache should have a CT scan performed within 12 hours of onset. […] A lumbar puncture must follow a reassuring CT scan to sufficiently exclude subarachnoid hemorrhage. […] Neuroimaging and an additional evaluation may be necessary to exclude life-threatening causes of headaches when red flags are present.

• #39 Diagnosis, Treatment & Management of Migraines | Banner

  https://www.bannerhealth.com/services/neurology/programs-care/headaches/migraines/diagnosis-and-treatment

  Even though no test can diagnose migraines, your provider may suggest certain tests or imaging studies to rule out other conditions or identify issues that might contribute to your headaches. […] Your doctor may recommend: […] Imaging studies (such as magnetic resonance imaging (MRI) or computed tomography (CT) scans) to check brain structure and rule out any underlying causes of the headaches. […] Sleep studies (polysomnography), to find out if sleep disorders such as sleep apnea could be adding to your headaches. […] Blood tests, which can look for inflammatory markers, hormonal imbalances, vitamin deficiencies and thyroid function issues. […] Lumbar puncture (spinal tap) to analyze the cerebrospinal fluid for signs of infection, inflammation or other problems. […] Electroencephalogram (EEG), which measures the brain’s electrical activity. […] Allergy testing, such as skin prick tests or blood tests, to see if allergies might be triggering your headaches.

• #40 When to order laboratory tests for your patient with a headache | Medmastery

  https://www.medmastery.com/guides/headaches-clinical-guide/when-order-laboratory-tests-your-patient-headache?srsltid=AfmBOooAe-HJJcMaRdwE7Sa7XMiHHW9RsZ18IiuqeYETZpnvnPcww0wn

  Laboratory tests can help you identify the cause of your patient’s headaches. […] Laboratory tests for patients with headache may be helpful under certain circumstances. A complete blood count (CBC), thyroid function, and erythrocyte sedimentation rate (ESR) are basic tests that are helpful in evaluating some headache patients. […] ESR is used to assess for possible giant cell arteritis. Individuals over the age of 50 with new onset headache should have their ESR and / or C-reactive protein (CRP) levels checked to exclude temporal arteritis. […] Perform a lumbar puncture when infection or subarachnoid hemorrhage is suspected. […] In a patient with headache, lumbar puncture can be used to identify infection, subarachnoid hemorrhage and intracranial hypertension. […] An electroencephalogram, or EEG, is not considered useful in the evaluation of headache unless there are concomitant considerations present to consider epilepsy in the diagnosis, such as with atypical migraine aura or recurrent loss or clouding of consciousness.

• #41 Migraine Diagnosis | Science of Migraine

  https://www.scienceofmigraine.com/management/migraine-diagnosis-criteria

  Find International Headache Society (IHS) migraine diagnosis guidelines and key considerations that can help differentiate migraine from other headache disorders […] Although migraine is a common disease with substantial impact, it is underdiagnosed and undertreated. […] In the American Migraine Prevalence and Prevention Study (N = 18,968), a substantial proportion of people who met the International Classification of Headache Disorders, second edition (ICHD-2) criteria for migraine reported never having received a medical diagnosis of migraine. […] Furthermore, in an observational study (N = 2,991), 88% of people with a self-diagnosis or medical diagnosis of sinus headache were classified with migraine-type headache per International Headache Society (IHS) criteria. […] Migraine diagnosis is described in the third edition of the ICHD (ICHD-3), developed by the IHS.

• #42 Migraine Headache: Diagnosis and Current and Emerging Preventive Treatments

  https://www.psychiatrist.com/pcc/migraine-headache-diagnosis-current-emerging-preventive/

  Migraine is associated with considerable pain and disability. Accurate diagnosis that differentiates migraine from other primary and secondary headache disorders is needed, and clinicians should assess the patients risk of progressing to chronic migraine. […] Many patients will benefit from preventive treatment. Clinicians must know how to identify these patients and be familiar with the numerous preventive treatments. […] A key point to remember when assessing any patient with headaches is that a headache is a symptom, not a diagnosis. […] According to the ICHD-3, to be diagnosed with migraine, a patient must experience 5 attacks that last 4 to 72 hours if untreated; are accompanied by nausea and vomiting and/or light or sound sensitivity; and have at least 2 of the following characteristics: unilateral location, pulsating quality, moderate to severe pain intensity, or aggravation by routine physical activity.

• #43 Migraine Diagnosis | Science of Migraine

  https://www.scienceofmigraine.com/management/migraine-diagnosis-criteria

  Find International Headache Society (IHS) migraine diagnosis guidelines and key considerations that can help differentiate migraine from other headache disorders […] Although migraine is a common disease with substantial impact, it is underdiagnosed and undertreated. […] In the American Migraine Prevalence and Prevention Study (N = 18,968), a substantial proportion of people who met the International Classification of Headache Disorders, second edition (ICHD-2) criteria for migraine reported never having received a medical diagnosis of migraine. […] Furthermore, in an observational study (N = 2,991), 88% of people with a self-diagnosis or medical diagnosis of sinus headache were classified with migraine-type headache per International Headache Society (IHS) criteria. […] Migraine diagnosis is described in the third edition of the ICHD (ICHD-3), developed by the IHS.

• #44 Migraine Diagnosis | Science of Migraine

  https://www.scienceofmigraine.com/management/migraine-diagnosis-criteria

  Find International Headache Society (IHS) migraine diagnosis guidelines and key considerations that can help differentiate migraine from other headache disorders […] Although migraine is a common disease with substantial impact, it is underdiagnosed and undertreated. […] In the American Migraine Prevalence and Prevention Study (N = 18,968), a substantial proportion of people who met the International Classification of Headache Disorders, second edition (ICHD-2) criteria for migraine reported never having received a medical diagnosis of migraine. […] Furthermore, in an observational study (N = 2,991), 88% of people with a self-diagnosis or medical diagnosis of sinus headache were classified with migraine-type headache per International Headache Society (IHS) criteria. […] Migraine diagnosis is described in the third edition of the ICHD (ICHD-3), developed by the IHS.

• #45 Tension headache – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/tension-headache/diagnosis-treatment/drc-20353982

  If you have regular headaches, your health care professional may give you a physical and a neurological exam. Your care professional works to pinpoint the type and cause of your headaches using these approaches. […] Your doctor can learn a lot about your headaches from the information you provide about the pain. […] Your health care professional may prescribe medicines that help you have fewer headaches or headaches that are less painful. Preventive medicines may help if you have regular headaches that aren’t relieved by pain medicine and other therapies. […] Your health care professional monitors your treatment to see how the preventive medicine is working. In the meantime, overusing pain relievers may interfere with the effects of the preventive medicines. Ask your health care professional about how often to use pain relievers while you’re taking preventive medicine.

• #46 The differential diagnosis of chronic daily headaches: an algorithm-based approach | The Journal of Headache and Pain | Full Text

  https://thejournalofheadacheandpain.biomedcentral.com/articles/10.1007/s10194-007-0418-3

  Chronic daily headaches (CDHs) refers to primary headaches that happen on at least 15 days per month, for 4 or more hours per day, for at least three consecutive months. […] The differential diagnosis of CDHs is challenging and should proceed in an orderly fashion. […] The clinical approach to diagnosing CDH is the scope of this review. […] An important first step in headache diagnosis is to distinguish primary from secondary CDH. […] Once secondary headache is excluded by history, physical and neurological examination and/or appropriate testing, the next step is to diagnose the primary headache disorder. […] In the absence of secondary CDH, the clinician proceeds to diagnose a primary CDH disorder. […] If the headache is atypical or difficult to classify, the possibility of secondary headache should be reconsidered, although the modifying effect of any treatment being taken should be kept in mind.

• #47 Cluster Headache: What It Is, Causes, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/5003-cluster-headaches

  Cluster headaches cause severe, one-sided head pain. […] A cluster headache is pain on one side of your head that lasts from 15 minutes up to three hours. […] A healthcare provider (a neurologist) will diagnose a cluster headache after a physical exam. […] Cluster headache treatment options may include: medications to prevent headaches and medications to manage pain during an attack. […] Unfortunately, there is no cure for cluster headaches. But you do have treatment options that can make them a little less painful or less frequent. […] If you suspect you have cluster headaches, reach out to a healthcare provider to confirm the diagnosis.

• #48 Cluster headache – Symptoms, diagnosis and treatment | BMJ Best Practice US

  https://bestpractice.bmj.com/topics/en-us/11

  Cluster headache is the most common trigeminal autonomic cephalalgia. This primary headache disorder is characterized by attacks of severe unilateral pain localized to the orbital, periorbital, and/or temporal areas that last from 15 to 180 minutes. […] Diagnosis is based on International Headache Society International Classification of Headache Disorders, 3rd edition (ICHD-3) criteria. […] Key diagnostic factors include repeated attacks of unilateral pain, short duration, excruciating pain, lacrimation, rhinorrhea, and partial Horner syndrome, as well as agitation and restlessness. […] 1st tests to order include brain and pituitary MRI without and with intravenous contrast, and erythrocyte sedimentation rate. […] Investigations to avoid include Electroencephalography (EEG). […] Tests to consider include pituitary function tests, magnetic resonance angiography (MRA) head and neck with and without contrast, brain CT scan, polysomnogram, and ECG.

• #49 Diagnosis and management of headaches in young people and adults: NICE guideline

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3722827/

  NICE has developed guidelines on management of primary headache disorders in young people and adults. The guideline is intended for non-specialist use, particularly for use in primary care where the majority of headaches can be safely diagnosed and managed. […] Improved recognition of the common headache disorders and better targeting of available treatments should reduce the burden of headache without requiring substantial additional resources. […] The guideline lists signs, symptoms, and possible conditions that should be considered before proceeding to a diagnosis of a primary headache disorder. […] The guideline includes recommendations on medication-overuse headache. This is headache that has developed or worsened after taking acute treatments for headache regularly for 3 months.

• #50 Migraine Diagnosis | Science of Migraine

  https://www.scienceofmigraine.com/management/migraine-diagnosis-criteria

  Transitioning between episodic migraine and chronic migraine may have implications for migraine classification and diagnosis. […] Both migraine-specific acute medications (eg, triptans, ergotamines, and ditans) and nonmigraine-specific acute medications (eg, analgesics and nonsteroidal anti-inflammatory drugs) are approved by regulatory agencies and/or recommended by professional society guidelines for relief from migraine attacks. […] Although some acute medications are indicated and/or recommended for aborting attacks, acute treatments can be overused, potentially leading to medication overuse headache (MOH), a type of secondary headache disorder. […] Approximately 50% of patients with chronic migraine have MOH that may revert to episodic headache after drug withdrawal. […] The ICHD-3 criteria for acute medication overuse differ based on the drug class. […] Overuse of acute medications may also be a risk factor for the conversion of episodic migraine to chronic migraine.

• #51 Migraine Diagnosis | Science of Migraine

  https://www.scienceofmigraine.com/management/migraine-diagnosis-criteria

  Transitioning between episodic migraine and chronic migraine may have implications for migraine classification and diagnosis. […] Both migraine-specific acute medications (eg, triptans, ergotamines, and ditans) and nonmigraine-specific acute medications (eg, analgesics and nonsteroidal anti-inflammatory drugs) are approved by regulatory agencies and/or recommended by professional society guidelines for relief from migraine attacks. […] Although some acute medications are indicated and/or recommended for aborting attacks, acute treatments can be overused, potentially leading to medication overuse headache (MOH), a type of secondary headache disorder. […] Approximately 50% of patients with chronic migraine have MOH that may revert to episodic headache after drug withdrawal. […] The ICHD-3 criteria for acute medication overuse differ based on the drug class. […] Overuse of acute medications may also be a risk factor for the conversion of episodic migraine to chronic migraine.

• #52 Migraine Headache Differential Diagnoses

  https://emedicine.medscape.com/article/1142556-differential

  When headache is episodic and recurrent and follows a well-established pattern, the patient likely has a primary headache disorder (ie, headaches with no organic or structural etiology). Differentiating migraine from other primary headaches (eg, muscle contraction tension headache, cluster headache) is important, as optimal treatment may differ. […] Migraine may also may simulate or be simulated by secondary headache disorders or coexist with a secondary headache disorder. Any of the following features suggest a secondary headache disorder and warrant further investigation: The first or worst headache of the patient’s life, especially if rapid in onset. A change in frequency, severity, or clinical features of the attack. New progressive headache that persists for days. Precipitation of headache with Valsalva maneuvers (ie, coughing, sneezing, bearing down). The presence of associated neurologic signs or symptoms (eg, diplopia, loss of sensation, weakness, ataxia). Onset of headaches after the age of 55 years. Headache developing after head injury or major trauma. Persistent, 1-sided throbbing headaches. Headache accompanied by stiff neck or fever. Atypical history or unusual character that does not fulfill the criteria for migraine. Inadequate response to optimal therapy.

• #53

  https://link.springer.com/article/10.1007/s10072-004-0300-x

  In most cases, diagnosis of the various headache subtypes is possible through the accurate collection of medical history data. […] However, sometimes serious problems of differential diagnosis may be encountered. […] Therefore, the distinction between migraine without aura and tension-type headache is not always easy, the relationship between chronic migraine and medication overuse headache is a complex one, and differentiation of chronic tension-type headache vs. new daily-persistent headache is often problematic. […] A clear knowledge of the distinctive clinical features of the various headache subtypes is necessary to establish a correct diagnosis in the group of unilateral headaches with short-lived attacks and in the group of headaches with nocturnal onset.

• #54

  https://link.springer.com/article/10.1007/s10072-004-0300-x

  In most cases, diagnosis of the various headache subtypes is possible through the accurate collection of medical history data. […] However, sometimes serious problems of differential diagnosis may be encountered. […] Therefore, the distinction between migraine without aura and tension-type headache is not always easy, the relationship between chronic migraine and medication overuse headache is a complex one, and differentiation of chronic tension-type headache vs. new daily-persistent headache is often problematic. […] A clear knowledge of the distinctive clinical features of the various headache subtypes is necessary to establish a correct diagnosis in the group of unilateral headaches with short-lived attacks and in the group of headaches with nocturnal onset.

• #55 Acute Headache – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK554510/

  Headache is a nearly universal complaint. Most headaches are benign, and most patients can be safely treated and discharged with minimal workup. However, many serious and life-threatening conditions may present with headaches. Recognition, evaluation, and appropriate management of these dangerous secondary headaches are critical to preventing long-term disability or death. […] Headache, or pain in any part of the head, is a nearly universal ailment. Headaches comprise 3% of emergency department chief complaints. While most headaches are benign (96%), recognizing less common, emergent causes of headaches is critical, as a timely intervention may be life-saving. […] The primary role of the emergency provider (EP) is to carefully analyze specific aspects of the history and physical exam to determine which patients are at risk for serious underlying pathology. The emergency provider must decide which patients require immediate further testing, such as laboratory studies and imaging, to confirm the diagnosis and direct management.

• #56 Headache Differential Diagnosis & Documentation

  https://blog.thesullivangroup.com/differential-diagnosis-for-headache-documentation-pearls

  Headache is a common reason for a visit to practitioners in primary care, urgent care, and emergency medicine. Patients with the chief complaint of non-traumatic headache comprise 3% of all emergency department visits. […] The foundation of high-quality, defensible care consists of a systematic approach to the differential diagnosis for headache supported by compulsive documentation. […] The essence of liability reduction in the care of patients with headache is to construct a medical record that provides a thorough, clear and logical explanation for the examiners thoughts and actions. […] Document a differential diagnosis and discuss your reasoning regarding the likelihood (or not) of serious causes for headache, including SAH, intracranial hemorrhage, mass lesion, CNS infection, meningitis, temporal arteritis, glaucoma, hypertensive crisis, pseudotumor cerebri, migraine, tension, cluster, pre-eclampsia, sinusitis. […] Most headache malpractice suits occur with patients who are sent home rather than admitted. The most important tool for providing good care and reducing liability is clear communication with patients and their families.

• #57 Acute Headache in Adults: A Diagnostic Approach | AAFP

  https://www.aafp.org/pubs/afp/issues/2022/0900/acute-headache-adults.html

  Patients with headache and red flags (acute thunderclap headache, fever with meningeal irritation on physical examination, papilledema with focal neurologic signs or impaired consciousness, concern for acute glaucoma) in their history or physical examination warrant further investigation for secondary causes of headache. […] Patients with stable primary headache disorders (i.e., no red flags and normal neurologic examination) do not need neuroimaging. […] Migraine headache is classically underdiagnosed. Patients for whom a diagnosis of migraine should be considered include those with recurring sinus headaches or recurrent severe headaches with a normal neurologic examination. […] Patients presenting with acute thunderclap headache should have a CT scan performed within 12 hours of onset. […] A lumbar puncture must follow a reassuring CT scan to sufficiently exclude subarachnoid hemorrhage. […] Neuroimaging and an additional evaluation may be necessary to exclude life-threatening causes of headaches when red flags are present.

• #58 Headache, differential diagnosis | Time of Care

  https://www.timeofcare.com/headache-differential-diagnosis/

  The International Classification of Headache Disorders 3rd edition classifies headaches into primary and secondary headaches. […] Primary headaches are headache syndromes not due to another cause. Primary headaches are often chronic and the diagnosis is established early in adulthood. […] Secondary headache syndromes are due to other causes (e.g. systemic illness or neurological abnormalities). […] Headache attributed to trauma or injury to the head and/or neck. […] Headache attributed to cranial or cervical vascular disorder. […] Headache attributed to non-vascular intracranial disorder. […] Headache attributed to a substance or its withdrawal. […] Headache attributed to infection. […] Headache attributed to disorder of homeostasis. […] Headache or facial pain attributed to disorder of the cranium, neck, eyes, ears, nose, sinuses, teeth, mouth or other facial or cervical structure. […] Headache attributed to psychiatric disorder.

• #59 Migraine Headache Workup: Approach Considerations, Indications for Neuroimaging, Lumbar Puncture Indications

  https://emedicine.medscape.com/article/1142556-workup

  Migraine is a clinical diagnosis. Diagnostic investigations are performed for the following reasons: […] The choice of laboratory and/or imaging studies is determined by the individual presentation. […] The development of an objective, quantitative biologic measurement of headache-pain severity could help to improve the diagnosis of migraine and enable more accurate assessments of treatment efficacy. […] A 2013 study suggested that high peripheral blood levels of calcitonin gene-related peptide (CGRP), a neurotransmitter that causes vasodilation, can aid in the diagnosis of chronic migraine by serving as a biomarker for permanent trigeminovascular activation. […] Neuroimaging is not necessary in patients with a history of recurrent migraine headaches and a normal neurologic examination. Neuroimaging is indicated for any of the following: […] Indications for LP include the following: […] Neuroimaging (CT or MRI scan) should precede LP to rule out a mass lesion and/or increased intracranial pressure.

• #60 Migraine Headache Workup: Approach Considerations, Indications for Neuroimaging, Lumbar Puncture Indications

  https://emedicine.medscape.com/article/1142556-workup

  Migraine is a clinical diagnosis. Diagnostic investigations are performed for the following reasons: […] The choice of laboratory and/or imaging studies is determined by the individual presentation. […] The development of an objective, quantitative biologic measurement of headache-pain severity could help to improve the diagnosis of migraine and enable more accurate assessments of treatment efficacy. […] A 2013 study suggested that high peripheral blood levels of calcitonin gene-related peptide (CGRP), a neurotransmitter that causes vasodilation, can aid in the diagnosis of chronic migraine by serving as a biomarker for permanent trigeminovascular activation. […] Neuroimaging is not necessary in patients with a history of recurrent migraine headaches and a normal neurologic examination. Neuroimaging is indicated for any of the following: […] Indications for LP include the following: […] Neuroimaging (CT or MRI scan) should precede LP to rule out a mass lesion and/or increased intracranial pressure.

• #61 Headache Tests | National Headache Foundation

  https://headaches.org/resources/headache-tests/

  These tests can help you communicate the severity of your headache pain to your doctor and/or help you identify a migraine. […] If you need a diagnosis or are seeking treatment, please visit our Provider Finder page to locate a healthcare provider in your area. […] Answering yes to two out of three of these questions means theres a 81% chance you have migraine. […] Answering yes to all three means theres at least a 93% chance you have migraine. […] Please schedule an appointment soon with your primary care provider and share your symptoms. […] Healthcare providers should evaluate the following symptoms to determine if a patient has migraine: […] The MIDAS score looks at the patients medical needs and helps the healthcare provider to determine the appropriate treatment at the first consultation.

• #62 Headache Tests | National Headache Foundation

  https://headaches.org/resources/headache-tests/

  These tests can help you communicate the severity of your headache pain to your doctor and/or help you identify a migraine. […] If you need a diagnosis or are seeking treatment, please visit our Provider Finder page to locate a healthcare provider in your area. […] Answering yes to two out of three of these questions means theres a 81% chance you have migraine. […] Answering yes to all three means theres at least a 93% chance you have migraine. […] Please schedule an appointment soon with your primary care provider and share your symptoms. […] Healthcare providers should evaluate the following symptoms to determine if a patient has migraine: […] The MIDAS score looks at the patients medical needs and helps the healthcare provider to determine the appropriate treatment at the first consultation.

• #63 Diagnosis and management of headaches in young people and adults: NICE guideline

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3722827/

  The diagnosis of primary headache disorders and in particular the diagnosis of menstrual migraine requires observation over 2-3 months and a headache diary can be useful for diagnosis, as a basis for discussion between practitioner and patient, and to monitor the effectiveness of interventions. […] Patients with a diagnosis of primary headache should not be referred for neuroimaging solely for reassurance. […] The guideline recommends aspirin, paracetamol, or NSAIDs for acute treatment of tension-type headache. […] The guideline recommends combination treatment with a triptan and paracetamol or a triptan and NSAID for migraine ahead of monotherapy on the basis of clinical and cost-effectiveness evidence. […] The decision as to when to commence prophylaxis depends on patient choice.

• #64 Headache: What It Is, Types, Causes, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/9639-headaches

  Although scans and other imaging tests can be important when ruling out other diseases, they don’t help in diagnosing migraines, cluster or tension-type headaches. […] Treatment for headaches depends on the type. […] Once you know your triggers, your healthcare provider can tailor treatment to you. […] The key to preventing headaches is figuring out what triggers them. […] Treating health problems that cause headaches, such as high blood pressure, can eliminate head pain.

• #65 Diagnosis and management of headaches in young people and adults: NICE guideline

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3722827/

  The diagnosis of primary headache disorders and in particular the diagnosis of menstrual migraine requires observation over 2-3 months and a headache diary can be useful for diagnosis, as a basis for discussion between practitioner and patient, and to monitor the effectiveness of interventions. […] Patients with a diagnosis of primary headache should not be referred for neuroimaging solely for reassurance. […] The guideline recommends aspirin, paracetamol, or NSAIDs for acute treatment of tension-type headache. […] The guideline recommends combination treatment with a triptan and paracetamol or a triptan and NSAID for migraine ahead of monotherapy on the basis of clinical and cost-effectiveness evidence. […] The decision as to when to commence prophylaxis depends on patient choice.

• #66 Diagnosis and management of headaches in young people and adults: NICE guideline

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3722827/

  The diagnosis of primary headache disorders and in particular the diagnosis of menstrual migraine requires observation over 2-3 months and a headache diary can be useful for diagnosis, as a basis for discussion between practitioner and patient, and to monitor the effectiveness of interventions. […] Patients with a diagnosis of primary headache should not be referred for neuroimaging solely for reassurance. […] The guideline recommends aspirin, paracetamol, or NSAIDs for acute treatment of tension-type headache. […] The guideline recommends combination treatment with a triptan and paracetamol or a triptan and NSAID for migraine ahead of monotherapy on the basis of clinical and cost-effectiveness evidence. […] The decision as to when to commence prophylaxis depends on patient choice.

• #67 Diagnosis and management of headaches in young people and adults: NICE guideline

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3722827/

  The most cost-effective prophylactic treatment is topiramate, although its side-effect profile and teratogenic potential may preclude its use in some patients. […] Combined hormonal contraception should not be used if a woman has migraine with aura because of a possible increased risk of ischaemic stroke. […] Oxygen and/or subcutaneous or nasal triptan, are recommended for the treatment of cluster headache. […] Overused medication must be withdrawn completely and is best stopped abruptly for at least 1 month. […] These guidelines should support GPs with the diagnosis of primary headache disorders.

• #68 Headache Diagnosis and Treatment | Brain Institute | OHSU

  https://www.ohsu.edu/brain-institute/headache-diagnosis-and-treatment

  Doctors at the OHSU Headache Center work closely with specialists in facial pain, dentistry and pregnancy. […] At OHSU, your care team will help you find the combination of therapies that works for you. Your care plan may include: A rescue plan you can use to treat a headache when it strikes. […] Many tension headaches can be treated with over-the-counter medications. […] Treating migraines requires a two-pronged approach: Acute therapy to treat pain when a migraine strikes. […] Breathing 100 percent oxygen through a nose or face mask for about 15 minutes can ease a cluster headache. […] Treatments for cervicogenic headaches focus on the upper (cervical) spine, where these headaches start.

• #69 Diagnosis and management of headaches in young people and adults: NICE guideline

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3722827/

  The most cost-effective prophylactic treatment is topiramate, although its side-effect profile and teratogenic potential may preclude its use in some patients. […] Combined hormonal contraception should not be used if a woman has migraine with aura because of a possible increased risk of ischaemic stroke. […] Oxygen and/or subcutaneous or nasal triptan, are recommended for the treatment of cluster headache. […] Overused medication must be withdrawn completely and is best stopped abruptly for at least 1 month. […] These guidelines should support GPs with the diagnosis of primary headache disorders.

• #70 Acute Headache – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK554510/

  Treatment of primary headaches in the emergency department should be focused on reducing symptoms and providing supportive care. […] Treatment of a secondary headache depends on identifying and treating the underlying pathology. […] The differential diagnosis for headaches is broad. […] The prognosis of primary headaches is variable and depends on the sub-type. Primary headaches are often recurrent and thus create a heavy medical burden on both emergency medicine and primary care. […] Complications of primary headaches are most often secondary to the temporary loss of normal function that they pose and can include loss of workdays and productivity. […] It is critical for clinicians to consider secondary causes of headaches through a comprehensive primary and secondary survey to ensure that the underlying pathology of a patients headache is correctly managed, minimizing complications of late treatment.

• #71 Chronic Daily Headache: Diagnosis and Management | AAFP

  https://www.aafp.org/pubs/afp/issues/2014/0415/p642.html

  The most common complications of chronic daily headache, other than those related to untreated pain, are medication-induced adverse effects. […] Education about headache from medication overuse is essential. […] The indications for referral to a neurologist or headache specialist may include diagnostic uncertainty, unsuccessful outpatient therapy, or the desire to administer more specialized treatment, such as onabotulinumtoxinA.

• #72 Headaches – Types, Causes, Symptoms, Diagnosis, Treatment

  https://www.webmd.com/migraines-headaches/migraines-headaches-basics

  Headache Diagnosis […] Once you get your headaches diagnosed correctly, you can start the right treatment plan for your symptoms. […] The first step is to talk to your doctor about your headaches. Theyll give you a physical exam and ask about your symptoms and how often they happen. Its important to be as detailed as possible with these descriptions. Give your doctor a list of things that cause your headaches, things that make them worse, and what helps you feel better. You can track details in a headache diary to help your doctor diagnose your problem. […] Most people dont need special diagnostic tests. But sometimes, doctors suggest a CT scan or MRI to look for problems inside your brain that might cause your headaches. Skull X-rays wont help. An electroencephalogram (EEG) is also unnecessary unless youve passed out when you had a headache. […] If your headache symptoms get worse or happen more often despite treatment, ask your doctor to refer you to a headache specialist.

• #73 Status of diagnosis and preventative treatment for primary headache disorders: real-world data of unmet needs in China | The Journal of Headache and Pain | Full Text

  https://thejournalofheadacheandpain.biomedcentral.com/articles/10.1186/s10194-023-01654-6

  Our research identified that prior utilization of preventive medication by those with migraine and TTH was recorded at 16.5% and 4.7%, respectively. […] Overall, it is the fact that primary headache sufferers are prone to comorbidities that makes it even more challenging to properly diagnose primary headache patients. […] These results highlight the pressing need for sustained campaigns and educational efforts worldwide to improve the diagnosis and treatment of primary headache disorders.

• #74 Status of diagnosis and preventative treatment for primary headache disorders: real-world data of unmet needs in China | The Journal of Headache and Pain | Full Text

  https://thejournalofheadacheandpain.biomedcentral.com/articles/10.1186/s10194-023-01654-6

  Our research identified that prior utilization of preventive medication by those with migraine and TTH was recorded at 16.5% and 4.7%, respectively. […] Overall, it is the fact that primary headache sufferers are prone to comorbidities that makes it even more challenging to properly diagnose primary headache patients. […] These results highlight the pressing need for sustained campaigns and educational efforts worldwide to improve the diagnosis and treatment of primary headache disorders.

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