Expert Headache Symptom Evaluation & Diagnosis
Headaches Are Symptoms with Many Possible Causes
At New Jersey Headache Institute, our focus on expert headache diagnosis is what allows us to properly treat the variety of headache causes. We take the time to carefully explore the patient's condition and ensure we are addressing the root cause of the headache. No other medical facility has comparable experience in migraine diagnosis and headache treatment in New Jersey.
Headache pain is one of the top reasons for doctor's visits in the United States, and migraines are the number one type of headache that leads patients to the emergency room. Twenty-eight million people in the US suffer from migraines. That means at least one person in every four American households. They tend to strike women more than men.
Technically, a headache is a symptom that can have a variety of causes. The International Headache Society has categorized headaches into primary and secondary disorders.
Secondary headaches tend to be caused by more serious conditions, disorders or diseases. They include headaches brought about by tumors, head trauma, aneurysms and brain inflammation or hemorrhaging, among other conditions.
Primary Headache Disorders
- Tension headaches
- Cluster headaches
- Exertion headaches
- Cough or sneeze induced headaches
- Cold Induced headaches
- Headaches associated with sexual activity
Secondary Headache Disorder Causes
- Brain hemorrhaging or inflammation
- Brain tumors or abscess
- Intracranial pressure
- Arteriovenous malformation
- Head trauma, and hematoma
- Encephalitis or meningitis
- Cerebrovascular disease
- Sinusitis Neuralgias
With a complete neurological examination and patient history, we can determine the type of headache a patient has. Using these questions can help in diagnosing headaches as either primary or secondary.
- What triggers your headaches?
- When did you first experience recurring headaches?
- Are there auras, flashing lights, numbness or other symptoms associated with your headaches?
- Does your family have a history of chronic headaches?
- What is the description, severity and location of your headache pain?
- What headache treatments have you received in the past?
These features are particularly useful in migraine diagnosis.
- Family history of migraines
- Changes in location of headaches
- Reliable headache pattern
- Prodromes or auras
- Good overall health
- Menstrual association
- Sleep resolution
- Meets IHS criteria
Instances that can Signal a secondary Headache Disorder
Often a patient with a secondary headache disorders will exhibit signaling items in their examination and history. These items will alert the doctor to the need for further evaluation. The following are lists of items that could signal a secondary headache disorder.
- Warrants Further Evaluation:
- Headache onset after age 50
- Changes in headache pattern
- First or worst headache ever experienced
- A headache that resists treatment
- A subacute headache that progressively worsens
- Headaches induced by sneezing, coughing, exertion or sex
Physical Examination Signals
- Stiffness in the neck
- Weight loss
- Chronic nasal drainage or cough
- Tender temporal arteries
Neurological Examination Signals
- Weakness or drowsiness
- Loss of coordination
- numbness or paralysis
- Sensory loss
- Confusion or memory loss
- Meningeal irritation
- Neurological changes
MRI & CT Scan Diagnosing
Headaches and migraines can usually be diagnosed without using neuroimaging technology. In expert headache diagnosis, neuroimaging is generally used to rule out secondary headache disorders. For acute headaches where head trauma or bleeding is suspected, a CT scan should be used. The following are guidelines for when to use MRI and CT scans in diagnosing headaches.
- Headache onset after the age of 50
- Worst or first headache ever experienced
- An abnormal neurological examination
- Headache pattern change
- Increased headache frequency and/or severity
- Sudden onset from sneezing, coughing, exertion or sex
Migraines Throughout History
- Sigmund Freud, psychoanalyst
- Julius Caesar, Roman emperor
- Napoleon Bonaparte, French emperor
- Michelle Akers, US soccer player
- Kareem Abdul Jabbar, Los Angeles Laker