The role of the physical examination in the evaluation of headache

The population of patients suffering with headaches is vast and underserved. The most critical element in headache evaluation is the history. The targeted history not only differentiates primary from secondary headaches but also provides a realistic list of conditions associated with secondary headache. Several of these conditions do present with specific physical findings, such as papilledema, Horner's syndrome, or CN palsy. The targeted physical examination of the patient with headache takes less than 3 minutes. The ability simply to recognize but a few straightforward clinical findings directs the evaluation in the proper direction. If you enjoy seeing patients, feel competent identifying but a few physical findings, and understand the basics of primary and secondary headaches and facial pain, there is urgent need of your services.