What are serious signals of headache symptoms that require immediate diagnosis and medical care?
Danger signals in headache patients Presence of following danger signals should warn a clinician that a headache may be more serious than migraine: • Headache that is changing or different from previous headaches may herald a brain tumor superimposed on a longstanding primary headache disorder, such as migraine or tension-type headache. • Headache with progressive worsening during 24 hours or several days suggest a mass lesion or infectious disease, such as meningitis, abscess, subdural or intracerebral hematoma, or vasculitis. • Headache precipitated by exertion, bending over, coughing or sneezing may result from transient blockage of CSF flow or increased intracranial pressure. • Sudden onset of headache during exercise or sex can occur with subarachnoid hemorrhage or could be benign exertional headache. • Vomiting may result from a brain tumor or other mass lesion with increased intracranial pressure. • Early morning headache can occur with obstructive sleep apnea and hypertension.
