From the Guidelines
When evaluating a headache, it is crucial to ask questions that help distinguish between different types of headaches, such as migraines, tension headaches, or cluster headaches, to provide appropriate treatment recommendations and improve patient outcomes. The most important questions to ask patients about their headaches include:
- The frequency and timing of headaches
- The character of the pain, such as dull, aching, throbbing, or piercing
- Associated symptoms like nausea, vomiting, sensitivity to light or sound, or neurological symptoms
- The location and duration of the pain
- Triggers or patterns, such as stress, sleep patterns, diet, or hydration
- Recent head trauma, current medications, or remedies already tried
- Family history of headaches As recommended by the most recent and highest quality study 1, taking a careful medical history and using validated diagnostic aids can help diagnose and manage migraines effectively. Some key questions to ask, as suggested by 1, include:
- How frequent are the headaches?
- What time of day do the headaches occur?
- What is the character of the pain?
- What other symptoms accompany the headache?
- Where is the pain located?
- How long do the headaches last?
- Do you take over-the-counter medications for your headaches?
- When you have these headaches, are you under any stress?
- What are your sleeping patterns?
- Is there a history of headaches in your family? By asking these questions and considering the patient's medical history, physical examination, and lifestyle factors, healthcare providers can develop an effective treatment plan to improve the patient's quality of life and reduce morbidity and mortality associated with headaches.
From the FDA Drug Label
The FDA drug label does not answer the question.
From the Research
Questions to Ask for a Headache
To diagnose and manage headaches, healthcare providers need to ask specific questions to identify the underlying cause and determine the best course of treatment. The following are some key questions to ask:
- What is the location and severity of the headache? 2, 3
- How often do the headaches occur and how long do they last? 4, 5
- Are there any triggers that cause the headaches, such as exertion or changes in posture? 2, 6
- Are there any associated symptoms, such as neurological symptoms, systemic symptoms, or signs of infection? 2, 3
- Has the patient experienced any recent head or neck injury? 2, 3
- Is the patient over the age of 50 or has a history of cancer or human immunodeficiency virus infection? 2
- Are there any red flag signs or symptoms, such as focal neurologic signs, papilledema, or sudden onset of the worst headache in the patient's life? 3, 6
Red Flag Signs and Symptoms
Red flag signs and symptoms can indicate serious underlying pathology and require further evaluation, including:
- Focal neurologic signs 3, 6
- Papilledema 3
- Neck stiffness 3
- Immunocompromised state 3
- Sudden onset of the worst headache in the patient's life 3, 6
- Personality changes 3
- Headache after trauma 3
- Headache that is worse with exercise 2, 3
Diagnostic Evaluation
The diagnostic evaluation of headaches includes: