Acute Headache Diagnosis and Management

A clinician's goal when encountering acute headaches is to distinguish primary and secondary headache disorders. A comprehensive history, screening for warning signs of secondary headache, and a physical examination can help determine if further workup is necessary. While neurodiagnostic testing is not indicated for individuals with a history of primary headache disorders with typical symptoms, individuals with atypical signs or symptoms may warrant brain imaging with MRI brain, CT head, CT angiogram, CTV, MRV, conventional cerebral angiography, spine imaging, and/or lumbar puncture. Secondary headaches should be treated for their underlying cause. Primary headache disorders have specific evidence-based treatments that can help with acute pain relief.