Sorting Through Headache Patterns

When headache is made a medical complaint, the headache is almost always migraine. However, the clinician should not be lulled into a sense of complacency. The first question rightly remains “Is this a primary (headache as disease) or secondary (headache as symptom)?” Red flags are helpful in identifying which headaches require further investigations and validated brief questionnaires have been developed for diagnosing migraine. Once a diagnosis is made, the patient should be told what is causing their headache and in the case of migraine that their headache is not the result of a serious threat to their life. It is important for the patient to accept that migraine alone is a sufficient explanation for their headache.