Acute Medicine | Neurology | How to take a headache history

How to Take a Headache History
Session Overview
Description
This session lists the key points to cover when taking a headache history. These will help you distinguish between headaches that need further investigation and those that do not.

Learning Objectives
By the end of this session you will be able to:

• Identify the key aspects of a headache history that point towards a secondary cause of headache (so-called ‘red flags’) and those features which reassure that the headache is primary (i.e. not associated with structural brain pathology)

Taking a headache history is a similar process to any other medical history but needs to cover certain ‘red flags’ to alert the physician to the possibility of significant intracranial pathology (secondary headache). Most headaches, even in the setting of Acute Medicine are not associated with any structural intracranial abnormality, and are termed primary headaches.

A well taken headache history will also look for some of the more subtle features of common headaches such as migraine. These are often missed in the first consultation, whoever sees the patient first should be aware of the importance of an accurate history to decrease concern and minimise the need for further investigations.