Headache Diagnostic Approach

The Migraine And Headache Program

Most Effective Migraine Headaches Treatments

Get Instant Access

History: most information is derived from determining:

- the first attack or previous attacks - site of headache

- whether onset is acute or gradual (days or weeks) - accompanying symptoms

- whether attacks have recurred for many years (chronic) - precipitating factors

The following table classifies causes in these categories:

Cause

Associated features

RECURRENT

Further investigations

which (if present)

ATTACKS

(if required)

aid diagnosis

ACUTE

Sinusitis

Preceding 'cold'

#

X-ray nasal sinuses

nasal discharge

Migraine

Visual/neurological

*

aura, nausea, vomiting

Cluster headache

Lacrimation, rhinorrhoea

*

Glaucoma

'Misting' of vision

*

Ophthalmological

'haloes' around objects

referral

Retrobulbar neuritis

Loss of vision (unilateral)

Visual evoked response

Post-traumatic

Following head injury

Skull X-ray, CT scan

Drugs/toxins

On vasodilator drugs

Haemorrhage

Instantaneous onset

vomiting, neck stiffness

CT scan.

impaired conscious level

' lumbar puncture

Infection (meningitis,

As above but more

*

(see page 54)

encephalitis)

gradual onset with pyrexia

(if CSF fistula)

Hydrocephalus

Impaired conscious level,

*

CT scan

leg weakness

impaired upward gaze

SUBACUTE

Infection (subacute.

Impaired conscious level.

CT scan

chronic meningitis,

pyrexia, neck stiffness,

lumbar puncture

e.g. TB

focal neurological signs

cerebral abscess)

Intracranial tumour

Vomiting, papilledema.

*

CT scan

Chronic subdural I

impaired conscious

haematoma f

level + focal neurological

Hydrocephalus J

signs

CT scan.

Benign intracranial

Vomiting, papilloedema

*

CSF pressure

hypertension

monitoring

Temporal arteritis

Thickened, tender.

ESR,

scalp arteries

temporal artery biopsy

CHRONIC

Tension-type headache

Anxiety, depression

*

Ocular 'eye strain'

Impaired visual acuity

*

Refractive errors

Drugs/toxins

On vasodilator drugs

Cervical spondylosis

Neck, shoulder, arm pain

*

X-ray cervical spine

Was this article helpful?

0 0
101 Power Tips For Preventing and Treating Headaches

101 Power Tips For Preventing and Treating Headaches

Are you fed up with your frequent headache pain? 101 Simple Ways to Attack Your Headache BEFORE the Pain Starts Guaranteed No Pain, No Fear, Full Control Normal Life Again Headaches can stop you from doing all the things you love. Seeing friends, playing with the kids... even trying to watch your favorite television shows.

Get My Free Ebook


Post a comment