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Headache Diagnosis

Headache Diagnosis is an important clinical skill, as 3% of acute medical admissions are for the assessment of headache.

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 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.



Non-cephalic infection is a common cause of acute headache with about 20% of cases having this diagnosis

Fortunately, serious diseases causing a severe headache are rare.

However, from the figure below, you will see that about 6-8% of all headaches requiring hospital assessment will have a serious cause identified.

Doctors attempting diagnosis of acute headache will need to be vigilant for those cases - one in every sixteen - who has a significant disease that may cause major harm if left undetected and untreated.

About one in every 16 acute headache cases in Craigavon Area Hospital has a serious diagnosis such as subarachnoid haemorrhage or meningitis or carbon monoxide poisoning



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NEW SURVEY: September 2011

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Chronic Migraine - the most common cause of severe headache



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