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Headache - assessment - Management
How should I assess someone presenting with a headache?
- Consider the possibility that more than one type of headache disorder is present.
- Assess for symptoms of:
- Examine for signs of secondary causes of headache. This examination should include at least:
- Measurement of blood pressure.
- Palpation of the temporal arteries, if the person is more than 50 years of age.
- A neurological examination, including fundoscopy for papilloedema.
- If the cause of the headache can not be diagnosed, consider:
- Asking the person to record a headache diary, and reviewing this in a few weeks.
- Diaries help to obtain an accurate description of symptoms necessary for diagnosis and may be particularly useful when symptoms are difficult to interpret due more than one type of headache disorder occurring in the same person.
- The diary should record each episode of headache, its severity, duration, any triggers (including postural changes suggestive of raised intracranial pressure), associated symptoms, and use of analgesia and caffeinated drinks.
- Referral for specialist assessment.
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