Diagnosis of Headache
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The doctor will ask about your symptoms and medical history, and perform a physical exam. The cause of a headache can be difficult to determine. The doctor will ask about the frequency and pattern of your headaches. To help provide answers, keep a diary of:
- When your headaches start and end
- What you were doing at the time
- What you did to try to relieve pain
- Family members with the same condition
- Triggers that you are aware of
- Where the pain is located and where it spreads to
- Other symptoms associated with the pain
Tests to determine the cause of headaches include:
Neurological exam—The doctor may perform a neurological exam to assess:
- Muscle strength
- Mental status
- Cranial nerve function
- Blood tests—Blood tests may be done to exclude other causes of your headache. These include blood sugar , a complete blood count looking for ]]>anemia]]> or infection, as well as other studies to potentially look for evidence of inflammation.
- ]]>X-rays]]> —X-rays of the neck may help determine if arthritis is contributing to a tension headache. Skull x-rays may be taken to check for structural changes responsible for ]]>sinusitis]]> .
- ]]>CT scan]]> —This is a type of x-ray that uses a computer to make pictures of structures inside the head. A CT scan is used to check for conditions that may cause headaches or to determine if a structural problem is causing chronic sinusitis.
- ]]>MRI scan]]> —This is a test that uses magnetic waves to make pictures of structures inside the head. An MRI scan can be used to check for any conditions ( ]]>tumor]]> or bleeding in head) that may be responsible for your headaches.
- Nasal endoscopy—The doctor uses a thin, lighted tube to look inside your nose and possibly take samples of drainage to be tested for ]]>allergies]]> or infection.
- ]]>Lumbar puncture]]> (LP, spinal tap)—During this procedure, spinal fluid is collected to look for bleeding, infections, or cancer.
Oftentimes, tests are done to rule out causes of your headaches.
Guidelines for All Doctors in the Diagnosis and Management of Migraine and Tension-Type Headache. 2nd ed. London, UK: British Association for the Study of Headache (BASH); 2004.
Headache—frequently asked questions. National Headache Foundation website. Available at: http://www.headaches.org/education/Tools_for_Sufferers/Headache_-_Frequently_Asked_Questions . Accessed September 11, 2008.
International classification of headache disorders. Cephalalgia. 2004;24:1-160.
International classification of headache disorders. Cephalalgia. 2005;25:460-465.
May A. A review of diagnostic and functional imaging in headache. J Headache Pain. 2006;7:174-184
NINDS headache information page. National Institute of Neurological Disorders and Stroke website. Available at: http://www.ninds.nih.gov/ . Updated July 2008. Accessed September 11, 2008.
Sahai-Srivastava S, Desai P, Zheng L. Analysis of headache management in a busy emergency room in the United States. Headache. 2008;48:931-938.
Last reviewed July 2008 by ]]>Rimas Lukas, MD]]>
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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