Diagnosis of headaches

Headaches are a near universal experience and one of the most common reasons for physician visits. The differential diagnosis of headaches is extensive with over 300 different types and causes. Most headaches can be diagnosed after the physician obtains a complete history and performs a pertinent general and neurologic examination. Although most headaches are of benign and still poorly understood origin, some of the secondary headaches can have serious and sometimes potentially life-threatening causes. This article reviews diagnosis of the following headaches: tension-type, migraine, cluster, greater occipital neuralgia, sinus headaches, trigeminal neuralgia, medication overuse or drug rebound headaches, headaches due to brain tumors, pseudotumor cerebri, lumbar puncture headache, acute severe new onset headaches (the 'first or worst'), headaches associated with sex, headaches following mild head injury and new onset headaches in patients over the age of 50.