Info

warning signs of headache

(should prompt neuroimaging)

  • Explosive onset (vasc)
    • “worst HA of life” (SAH, RCVS)
    • meningismus (SAH, infxn)
  • Positional:
    • lying >standing (↑ ICP)
    • N/V (↑ ICP; migraines)
    • coughing/bearing down (↑ ICP)
  • Visual sx:
    • diplopia, blurring, ↓ acuity (GCA, glaucoma, ↑ ICP)
    • eye pain
      • glaucoma,
      • trigeminal autonomic cephalalgia
      • optic neuritis
  • Abnl exam (struct. lesion, poss. in migraine)
    • ↓ consciousness
    • systemic sx (fever)
  • Age >65 y; immunosuppression (CNS infections, PRES)

Red Flags-SNOOP for headache