Headache red flags

Evidence-based neurology checklist on headache red flags: Sinister headache features Sudden severe headache Worsening of pre-existing headache New headache in pregnancy or post-partum Headache worse in the morning Headache worse with neck flexion/extension Headache worse in the upright posture…

Sinister headache features

  • Sudden severe headache
  • Worsening of pre-existing headache
  • New headache in pregnancy or post-partum
  • Headache worse in the morning
  • Headache worse with neck flexion/extension
  • Headache worse in the upright posture
  • Headache at the occipito-cervical junction
  • Cluster type headaches
  • Undefined headaches
  • Posttraumatic onset

Sinister triggering features

Sinister associated features

SNOOP4 red flags mnemonic

Headache green flags: indicators of primary headache

References

  1. Bigal ME, Lipton RB.  The differential diagnosis of chronic daily headaches: an algorithm-based approach. J Headache Pain 2007; 8:263-272.
  2. Dodick DW. Clinical clues and clinical rules-primary vs. secondary headache. Adv Stud Med 2003; 3(6C):S550-S555.
  3. Detsky ME, McDonald DR, Baerlocher MO, Tomlinson GA, McCrory DC, Booth CM. Does this patient with headache have a migraine or need neuroimaging? JAMA 2006; 296:1274-1283.
  4. Do TP, Remmers A, Schytz HW, et al. Red and orange flags for secondary headaches in clinical practice: SNNOOP10 list. Neurology 2019; 92:134-144.
  5. Lee VME, Ang LL, Soon DTL, Ong JJY, Loh VWK. The adult patient with headache. Singapore Med J 2018; 59:399-406. 
  6. And 1 more. Subscribe to see the full list

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