Primary and Secondary Headaches - Red Flags and Differential Diagnosis Red Flags (SNOOP): S - Systemic N - Neurologic Sx O - Onset New, Sudden O - Other Associated P - Previous Headache Sx change Migraine Headache: • Unilateral (60-70%), Bifrontal or Global (30%) • Gradual, Crescendo, Pulsating, Mod-Severe Intensity • Patient Prefers to Rest, Dark • 4h – 3 days • N/V, Photophobia, Phonophobia +/- aura (usually visuals) Tension Headache: • Bilateral • Pressure or Tightness which Waxes and Wanes • 30 min – 7 days Cluster Headache: • Always unilateral • Around Eye/Temple • Pain comes quickly, deep pain, continuous, excruciating, explosive • 15 min – 3 hr • Ipsilateral Lacrimation, Red Eye, Stuffy Nose, Pallor, Sweating, Focal Neurological Sx, Sensitivity ETOH Infection - Meningitis Trauma - Post-Trauma, Neck Manipulation Vascular - Subarachnoid Hemorrhage, Subdural hematoma, epidural hematoma, Pituitary Apoplexy, Venous Thrombosis, Giant Cell Arteritis, Carotid/Vertebral Dissection, AV Malformation Non-Vascular - Increased/Decreased ICP, Neoplasm, Seizure Substance - Carbon monoxide, ETOH, Cocaine, Histamine, Substance Withdrawal Infection - Meningitis, Encephalitis, Abscess Homeostasis - Hypoxia, Hypercapnia, Hypoglycemia Anatomy - Acute Glaucoma, Physiological - Amy Chung, MD, MSc @AmyChung #Headaches #diagnosis #differential #causes #primary #secondary #management #neurology
