Characteristic clinical feature or risk factor | Suspected etiology | Supportive associated features | Common alternative underlying causes |
History | |||
Anticoagulant medication use | Subdural hematoma |
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Analgesic medication use | Medication overuse headache |
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Pregnancy | Preeclampsia |
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Onset at age >50 years | Tumor |
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Immunosuppressive state | Infectious meningitis |
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Carbon monoxide exposure | Carbon monoxide toxicity |
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Symptoms | |||
Sudden-onset severe headache | Aneurysmal SAH |
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Visual disturbances | Glaucoma |
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Orthostatic headache | Spontaneous intracranial hypotension |
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Signs | |||
Fever and meningismus | Infectious meningitis |
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Elevated BP | RCVS |
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Papilledema | IIH (pseudotumor cerebri) |
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Horner syndrome | Carotid artery dissection |
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Drowsiness | ICH |
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Hemiplegia | ICH or ischemic stroke |
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BP: blood pressure; CVT: cerebral venous thrombosis; EDH: epidural hematoma; GCA: giant cell arteritis; ICH: intracerebral hemorrhage; IIH: idiopathic intracranial hypertension; RCVS: reversible cerebral vasoconstriction syndrome; RPLS: reversible posterior leukoencephalopathy syndrome; SAH: subarachnoid hemorrhage.
* Primary headache syndromes include migraine and related conditions, tension-type headaches, trigeminal autonomic cephalalgias (cluster headache, paroxysmal hemicrania, short-lasting unilateral neuralgiform headache attacks, and hemicrania continua), and less common primary headache disorders (eg, new persistent daily headache, primary cough headache, primary exercise headache). Refer to UpToDate topics for additional details.Do you want to add Medilib to your home screen?