Headache Red Flags

Question 1

What types of onset should be considered a red flag in a headache presentation?

Answer 1

1. Acute onset
2. Traumatic onset
3. New onset (under 50 y.o)

Question 2

Which substances are red flags for a headache presentation?

Answer 2

1. Anticoagulants (haemorrhage risk)
2. Cocaine (stroke risk)
3. Amphetamines (stroke risk)

Question 3

What other SSX would indicate a potential meningitis case in a headache presentation?

Answer 3

1. severe throbbing HA
2. extreme nuchal rigidity
3. photophobia
4. SSX infection

Question 4

What other SSX would indicate a potential stroke in a headache presentation?

Answer 4

1. dizziness
2. confusion / disorientation
3. Horner’s syndrome
4. tinnitus
5. speech deficit
6. difficulty swallowing
7. nausea / vomiting
8. numbness and/or weakness in arms, legs or face
9. loss of balance

Question 5

Which neurological SSX are red flags in a HA presentation?

Answer 5

1. mental state changes
2. seizures
3. vision change
4. vomiting
5. asymmetrical cranial nerve function
6. asymmetrical motor function
7. loss of balance / gait disturbance / clumsiness

Question 6

Which populations are a potential red flag for a headache presentation?

Answer 6

1. Hx malignancy
2. over 50 y.o.
3. tobacco use
4. unexplained weight loss
5. failure to improve with treatment / time