Template:HA red flags

Headache Red Flags

Features

• Sudden onset or accelerating pattern
• Maximum intensity of pain at onset (i.e. "thunderclap")
• Worse with valsalva
• Worse in the morning or at night
• No similar headache in past
• Age >50 yr or <5 yr
• Occipitonuchal headache
• Visual disturbances
• Exertional or postcoital
• Family or personal history of SAH, cerebral aneurysm, or AVM
• Focal neurologic signs
• Diastolic BP >120
• Papilledema
• Jaw claudication

Clinical Context

Headache in setting of:

• Infection
• Cancer
• Immunosuppression
• Seizure
• Syncope
• Trauma
• Altered mental status
• Systemic illness (fever, stiff neck, rash)
• Nausea/vomiting
• Patient on anticoagulation, steroids, NSAIDs, antiplatelet