CKS is no longer commissioned by the National Institute for Health and Clinical Excellence (NICE). NICE remains committed to providing a replacement service for CKS and is currently reviewing its options. In the meantime, although CKS content is now not being maintained, it still remains relevant and will continue to be made available. CKS content was generated under a programme of topic creation and update. To check if the topic you are viewing is current or out of date, please refer to the topic publication details by clicking on the 'How up-to-date is this topic?' link in the left hand menu on individual topic pages.
Headache - assessment - Management
How do I manage a person with headache?
- If a serious secondary cause of headache is suspected:
- Arrange immediate admission for people with a headache that is suspected to be secondary to:
- Epidural or subdural haematoma.
- Stroke, including subarachnoid haemorrhage.
- Intracranial infection, such as meningitis or encephalitis.
- Acute glaucoma.
- A suspected space occupying lesion associated with rapidly progressive neurological signs or seizures.
- For people with features indicating a higher risk for a space-occupying lesion, arrange urgent investigation either by:
- Urgent referral to a specialist (to be seen within 14 days), or
- Direct referral for brain imaging from primary care, where this is available.
- For people with features indicating a moderately increased risk for a space-occupying lesion, monitor carefully and have a low threshold for investigation.
- Manage people with headaches secondary to suspected:
- If the headache is thought to be secondary to other underlying causes, manage the underlying cause. CKS topics are available on the management of:
- If a primary headache disorder or trigeminal neuralgia is suspected, see the CKS topics on:
- If paroxysmal hemicrania or hemicrania continua is suspected, treat with indometacin and refer for specialist management.
- If there is no clear diagnosis following assessment, refer for specialist assessment of the cause.
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