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A detailed history and physical examination can distinguish between key features of benign primary headaches (e.g., tension-type, migraine, trigeminal autonomic cephalalgia) and concerning ...
The clinical features and diagnosis of specific primary headache syndromes are discussed separately: • (See "Pathophysiology, clinical manifestations, and diagnosis of migraine in adults".) • (See "Chronic migraine".)
Differential Diagnosis. The differential diagnosis for headaches is broad. Additional conditions that can be accompanied by headaches not yet discussed include:
Headache is pain localized to any part of the head, behind the eyes or ears, or in the upper neck. In the US in 2021, 6.2% of women and 2.2% of men reported being bothered a lot by headache or migraine in the past 3 months. Diagnostic clues should be derived primarily from history. Hallmark physi...
Differentiating migraine from other primary headaches (eg, muscle contraction tension headache, cluster headache) is important, as optimal treatment may differ. Migraine may also may simulate or...
The symptoms that are present when the headache is most severe are often the most useful in differentiating the different types of headache. Some migraine headaches can cause tearing, eye redness, and nasal congestion, but those symptoms usually involve both sides of the head when they occur with a migraine.
A contrast study is often recommended to increase the sensitivity and specificity to detect structural abnormalities. A need for vascular imaging is based on the differential diagnosis. Further studies may be warranted depending upon the underlying cause.
Where there is no clinically suspected secondary headache, a primary headache diagnosis should be sought and actively managed. The most prevalent primary headaches are migraine (∼15%), tension type headache (∼60%) and cluster headache (∼0.1%).
Abstract. Headache is an extremely common symptom and collectively headache disorders are among the most common of the nervous system disorders, with a prevalence of 48.9% in the general population. 1 Headache affects people of all ages, races and socioeconomic status and is more common in women. Some headaches are extremely debilitating and have significant impact on an individual’s quality ...
Consider a diagnosis of migraine in patients with recurrent severe disabling headaches associated with nausea and sensitivity to light, and with a normal neurological examination (C).