Headache

Abstract

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Acute headaches or marked exacerbation of long-standing headaches can present as an emergency. Patients with chronic headache disorders remain at the same risk as the background population for developing life-threatening new headache conditions such as subarachnoid hemorrhage or brain tumour. A comprehensive history, particularly the history of the presenting complaint, is crucial for correct diagnosis. A careful neurological examination looking for evidence of localizing signs secondary to a focal intracranial disturbance is considered. Differential diagnoses used for basic investigations are blood test, imaging, and lumbar puncture (LP). Obtain imaging to exclude an intracranial mass lesion or obstructive hydrocephalus in patients with impaired consciousness or focal neurological deficits or papilloedema prior to performing an LP due to the risk of acute tonsillar herniation, which results in permanent neurological disability or death.