Primary Headache
Symptoms of a primary headache do not exclude a secondary headache
Migraine
- Usually last 4-72h
- SAH or infection can be trigger for migraine
Tension type
- 30 min to 7 d long
Cluster HA and associated
Exertional
Secondary Headache
Headache is a high risk presentation for bad miss
SAH
- Can be a cause and thus a perfect mimic of migraine
Space occupying CS lesion (ICH, malignancy, hydrocephalus)
Head Injury
Elevated ICP
Meningitis
Dural sinus thrombosis
Acute Glaucoma
Temporal Arteritis
CO Poisoning
Dental or ENT Causes (Caries, Abscess, TMJ, AOM, Sinusitis, Strep throat)
Trigeminal neuralgia
Workup
- Exam needs to include eye, mouth/throat, ear exam
- New headache should get a head CT