Headaches are a frequent outpatient clinic and emergency department diagnosis. The vast majority are known as primary headaches, these headaches are characterized because of being the only symptom referred by the patient. No other signs or symptoms are associated that may suggest any other disease. Some types of primary headaches include, migraine, cluster headache, tensional headache among others. Secondary headaches on the contrary are a manifestation of another disease, such as meningitis, subarachnoid hemorrhage, cerebral tumors.
A properly performed medical examination and history may be enough to prompt a diagnosis and possible causes of headache During the interview it is important to determine if it has a subtle or acute presentation. Another important fact to establish is for how long the headache has been present, if it is constant or if there are time periods without any pain. Duration of headache, if it lasts seconds or hours, such a migraine, which can last for hours.
Another relevant information is the age at presentation, older patients > 50 y/o with sudden onset headache suggest secondary causes.
The decision to perform image studies is supported by the findings obtained during medical examination. In some cases, only a CT scan may be done, or an MRI or both.
Treatment will depend on the type of headache diagnosed and depending the cause it may include medical or surgical treatment.
