Diagnosing Secondary and Primary Headache Disorders. Issue 3 (June 2021)

• Record Type: Journal Article
• Authors: Dodick, David W.
• Is Part Of: Continuum. Volume 27:Issue 3(2021)
• Publication Date: 2021-06
• Subjects: Neurology -- Periodicals; Neurology -- Study guides -- Periodicals; Nervous system -- Diseases -- Periodicals; 616.8
• DOI: 10.1212/CON.0000000000000980
• Languages: English
• ISSNs: 1080-2371

Abstract

ABSTRACT: PURPOSE OF REVIEW: This article provides a systematic diagnostic approach to the patient with headache. RECENT FINDINGS: The vast majority of patients presenting with headache in clinical practice have a primary headache disorder. The most common primary headache disorder in clinical practice is overwhelmingly migraine. Unfortunately, a substantial proportion of patients with migraine do not receive an accurate diagnosis. In addition, the clinical features of migraine overlap with secondary causes of headache, making a careful history and deliberative evaluation for warning symptoms or signs of a secondary headache disorder of paramount importance. SUMMARY: The approach to the patient with headache requires knowledge of the diagnostic criteria for primary headache disorders, recognition of the importance of a systematic evaluation for red flags associated with secondary headache disorders, and awareness of the pearls and pitfalls encountered in the diagnostic evaluation of a patient with headache.