Headache - Clinical Symptoms

Clinical

Symptoms

Headache

Headache is a very common symptom. Most headaches do not have a serious cause. The history is the most important diagnostic tool.

As with most types of pain, specific features that must be enquired about include: Site, Onset, Character, Radiation, Associated symptoms, Timing, Exacerbating and relieving factors, and Severity (SOCRATES). The site of pain is sometimes generalised, but if focal may be described as frontal, occipital, temporal and either unilateral or bilateral. See Table 7.1.

Drugs, including recreational drugs and substances such as alcohol, nicotine and caffeine, can lead to headaches, either directly or during withdrawal.

Features that suggest a serious underlying disease:

·        Sudden onset

·        Severe pain

·        Associated neurological abnormalities

·        Impaired consciousness

·        Seizures

·        Previous head injury or history of fall or trauma

·        Signs of systemic illness