[Headache: physical exam or CT?].

Area of Science:

• Neurology
• Clinical Diagnostics

Background:

• Headache disorders are highly prevalent, affecting over 90% of the population.
• Migraine represents a significant portion of headache cases encountered in clinical practice.

Purpose of the Study:

• To introduce a simple clinical predictive score for diagnosing migraine.
• To identify criteria for excluding secondary headaches and guiding neuroimaging decisions.

Main Methods:

• Development of a 5-question clinical predictive score for migraine diagnosis.
• Review of evidence for prediction rules in secondary headache exclusion.
• Guidelines for neuroimaging in cases of unexplained neurological examination findings.

Main Results:

• A 5-question score can effectively confirm migraine diagnosis in most patients.
• Current evidence is insufficient for developing prediction rules to exclude secondary headaches.
• Neuroimaging is recommended for patients with unexplained abnormal neurological examinations.

Conclusions:

• A simple clinical score aids in accurate migraine diagnosis and reduces unnecessary investigations.
• Further research is needed for prediction rules in secondary headache.
• Clinical judgment and neurological examination remain crucial for identifying serious underlying conditions.