Diagnosis of Headache

The doctor will ask about your symptoms and medical history, and perform a physical exam. The cause of a headache can be difficult to determine. The doctor will ask about the frequency and pattern of your headaches. To help provide answers, keep a diary of:

  • When your headaches start and end
  • What you were doing at the time
  • What you did to try to relieve pain and how effective the treatment was
  • Family members with the same condition
  • Triggers that you are aware of
  • Where the pain is located and where it spreads to
  • Other symptoms associated with the pain
Tests to determine the cause of headaches include:
  • Neurological exam to assess:
    • Muscle strength
    • Coordination
    • Reflexes
    • Sensation
    • Mental status
    • Cranial nerve function
  • Blood tests—Blood tests may be done to exclude other causes of your headache. These include blood glucose, a complete blood count looking for anemia or infection, as well as other studies to potentially look for evidence of inflammation.
  • Lumbar puncture—During this procedure, spinal fluid is collected to look for bleeding, infections, or cancer. The opening pressure may also be measured.
Imaging tests are used to evaluate internal structures for abnormalities. Some tests may use contrast material to make structures easier to see. These may include:
  • X-rays.
  • CT scan
  • MRI scan
  • Nasal endoscopy—A thin, lighted tube with a camera is inserted into the nasal cavity. If needed, tissue samples can be taken for examination under a miroscope.

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