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Headache to worry about

J R Couch1

  • 1Department of Neurology, University of Oklahoma College of Medicine, Oklahoma City.

The Medical Clinics of North America
|January 1, 1993
PubMed
Summary
This summary is machine-generated.

New or unusual headaches warrant medical attention, especially when accompanied by neurological symptoms. Prompt evaluation is crucial for diagnosing serious conditions like temporal arteritis in older adults.

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Area of Science:

  • Neurology
  • Internal Medicine
  • Emergency Medicine

Background:

  • Headaches are a common symptom with a wide differential diagnosis.
  • Certain headache characteristics and associated symptoms indicate potentially serious underlying conditions.
  • Distinguishing benign headaches from those requiring urgent investigation is critical for patient outcomes.

Purpose of the Study:

  • To identify key features of headaches that necessitate immediate medical evaluation.
  • To highlight specific neurological signs and patient demographics associated with severe headache etiologies.
  • To emphasize the importance of timely diagnostic testing for specific headache types.

Main Methods:

  • Review of clinical presentations of various headache types.

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  • Analysis of associated neurological deficits and their significance.
  • Consideration of age-related risk factors for specific headache pathologies.
  • Main Results:

    • Headaches differing from previous patterns, especially with acute onset, are concerning.
    • Meningismus and focal neurological symptoms (e.g., oculoparesis, hemiparesis, altered consciousness) are red flags.
    • Subacute headaches in older adults may suggest arteritis/vasculitis, requiring sedimentation rate testing.

    Conclusions:

    • Patients presenting with new-onset, atypical headaches, particularly those with neurological signs, require urgent assessment.
    • Temporal arteritis must be considered in individuals over 50 with new headaches, necessitating sedimentation rate testing.
    • Early diagnosis and management of serious headache causes can prevent devastating outcomes.