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"WHICH Headache to Investigate, WHEN, and HOW?"

K Ravishankar1

  • 1Consultant In-Charge, The Headache and Migraine Clinic, Jaslok Hospital and Research Centre, Lilavati Hospital and Research Centre, Mumbai, India.

Headache
|November 1, 2016
PubMed
Summary
This summary is machine-generated.

Investigating headaches requires careful consideration to avoid missing serious secondary causes. This article guides clinicians on selecting appropriate diagnostic tests for various headache presentations, emphasizing judicious test selection over exhaustive batteries.

Keywords:
imaging in headacheimaging protocolinvestigationred flagssecondary headaches

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Area of Science:

  • Neurology
  • Diagnostic Imaging

Background:

  • Headaches are common, categorized as primary (no structural cause) or secondary (underlying condition).
  • Secondary headaches, though less common, can indicate serious, life-threatening conditions.
  • Investigating headaches is crucial to rule out ominous secondary causes, but challenging presentations can complicate diagnosis.

Purpose of the Study:

  • To provide an approach for appropriate investigation in patients with elusive headache scenarios.
  • To guide clinicians on selecting specific diagnostic tests based on working diagnoses.
  • To advocate for judicious test ordering over exhaustive testing in all headache patients.

Main Methods:

  • Review of challenging headache presentations and diagnostic strategies.
  • Discussion on the role of advancing technology and clinical expertise in headache investigation.
  • Emphasis on differential diagnosis and targeted investigation.

Main Results:

  • Elusive headache scenarios require a nuanced approach to investigation.
  • Clinical expertise allows for judicious selection of diagnostic tests.
  • Moving away from exhaustive testing towards targeted investigations is recommended.

Conclusions:

  • Appropriate investigation of headaches hinges on timely and accurate diagnosis.
  • Clinicians should develop expertise in selecting specific tests based on working diagnoses.
  • A tailored approach to headache investigation improves diagnostic accuracy and efficiency.