Patients presenting with headaches need to be screened for primary vs secondary etiologies. “Red flags” associated with secondary headaches are crucial to identify. Physical examination should be completed with careful assessment of clues obtained during the history. It should include blood pressure measurements, assessment of mental status, and cranial nerve (CN) examination including but not limited to fundoscopic examination, gait, and facial strength.
headache
ICHD-II Diagnostic Criteria for Headache Attributed to Head and/or Neck Trauma
Acute post-traumatic headache attributed to moderate or severe head injury
A. Headache, no typical characteristics known, fulfilling criteria C and D
B. Head trauma with at least one of the following:
ICHD-II Diagnostic Criteria for Tension-type headache (TTH)
A. At least 10 episodes occurring on <1 day/month on average (<12 days/year) and fulfilling criteria B-D
B. Headache lasting from 30 minutes to 7 days
C. Headache has at least 2 of the following characteristics:
ICHD-II Diagnostic Criteria for Headache Attributed to Non-Vascular Intracranial Disorder
A. Progressive headache with at least 1 of the following characteristics and fulfilling criteria C-D:
- Daily occurrence
- Diffuse and/or constant (non-pulsating) pain
- Aggravated by coughing or straining
ICHD-II Diagnostic Criteria for Cluster Headache
Cluster headache
A. At least 5 attacks fulfilling criteria B-D
B. Severe or very severe unilateral orbital, supraorbital and/or temporal pain lasting 15-180 minutes if untreated
C. Headache is accompanied by at least 1 of the following: