Headache Diagnosis

Headache Diagnosis is an important clinical skill.

As 3% of acute medical admissions are for the assessment of headache, anyone involved in the acute medical take will put this skill to good practice.

An important, but often forgotten point, is that prior knowledge of likely or potential diagnoses strongly influences the final diagnosis.

The clinical setting is extremely important.

In primary care, the frequency of serious disorders is very low, so your headache diagnoses are very heavily skewed towards tension-type and migraine headache.

In Accident and Emergency, even though the risk of a serious disease is still low (<10%), dangerous headache disorders such as subarachnoid haemorrhage appear as a realistic diagnostic option almost every day.

What appears to be interesting from our own surveys in Craigavon Area Hospital is that headaches associated with non-cephalic infections are a very frequent occurrence, accounting for about 20% of acute headache cases.

However, doctors attempting diagnosis in acute settings will need to be vigilant for those relatively rare cases - one in every sixteen - who has a significant disease that may cause major harm if left undetected and untreated.