HEADACHE : May be you are searching

in #headache7 years ago (edited)

Differential diagnosis

The vast majority of headaches are benign, but when taking a history do not forget to ask about the following (early diagnosis can save lives):

Worrying features or ‘red flags’

First and worst headache—subarachnoid haemorrhage.
Thunderclap headache—subarachnoid haemorrhage.
Unilateral headache and eye pain—cluster headache, acute glucoma.
Unilateral headache and ipsilateral symptoms—migraine, tumour, vascular.
Cough-initiated headache—increased ICP/venous thrombosis.
Worse in the morning or bending forward—increase ICP/venous thrombosis.
Persisting headache ± scalp tenderness in over-50s—giant cell arteritis.
Headache with fever or neck stiff nesspic-1.jpg—meningitis.

Two other vital questions:
• Where have you been? (Malaria).
• Might you be pregnant? (Pre-eclampsia; especially if proteinuria and increase BP.)

Always examine a patient presenting with a severe headache; if nothing about history or examination is concerning, both you and the patient will be reassured, but subtle abnormalities are important not to miss.

Ref: OXFORD HANDBOOK OF CLINICAL MEDICINE. 10th edition.

If you enjoyed this article, please give me a comment, an upvote, or a resteem! I'll share more of what you love the most.

Follow me: @knowledge4all