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Practical evaluation and diagnosis of headache
1New England Center for Headache, Stamford, Connecticut 06902-1249, USA.
Seminars in Neurology
|January 1, 1997
Summary
Accurate headache diagnosis relies on a thorough patient history and neurological exam. Understanding primary versus secondary headaches guides appropriate testing and treatment for conditions like migraine or those caused by underlying issues.
Area of Science:
- Neurology
- Diagnostic Medicine
Background:
- Effective headache management hinges on a strong physician-patient relationship.
- Comprehensive patient history is paramount for accurate diagnosis.
Purpose of the Study:
- To outline the essential components of a headache evaluation.
- To differentiate between primary and secondary headache disorders.
Main Methods:
- Detailed patient history including onset, intensity, character, aura, autonomic symptoms, triggers, and medication overuse.
- Thorough neurological examination.
- Classification of headaches into primary and secondary types.
Main Results:
- A normal neurological exam often obviates the need for further diagnostic tests.
- Primary headaches (migraine, tension-type, cluster, analgesic-rebound) lack structural causes.
- Secondary headaches stem from underlying pathologies (e.g., increased intracranial pressure, tumors, infections).
Conclusions:
- Accurate headache diagnosis is crucial for appropriate further testing.
- Correct diagnosis guides effective patient treatment strategies.