II. Diagnostics
-
Head CT or Head MRI
- See Neuroimaging in Headache
- See Organic Headache
- Focal neurologic symptoms or signs
- Progressive Headaches
- Symptoms of increasing Intracranial Pressure
- Indications to obtain head imaging prior to Lumbar Puncture
- Suspected Increased Intracranial Pressure
- CNS mass
- Headache in HIV
- Altered neurologic exa
-
Head CT Venogram or the preferred MR Venogram
- Cerebral Venous Sinus Thrombosis
-
Lumbar Puncture (LP)
- Fever (Meningitis or Encephalitis suspected)
- Do not delay antibiotics if Bacterial Meningitis is suspected (but attempt to get Lumbar Puncture first if possible)
- Subarachnoid Hemorrhage
- LP indicated in Thunderclap Headache with negative CT Head
- Fever (Meningitis or Encephalitis suspected)
-
Lumbar Puncture with opening pressure
- Increased Intracranial Pressure (e.g. Pseudotumor Cerebri)
- Cerebral venous sinus thrombosis (opening pressure)
- Idiopathic Intracranial Pressure (similar to Spinal Headache)
- XRay C-Spine
- Rarely useful in Headache Evaluation
-
Electroencephalogram (EEG)
- Rarely useful in Headache Evaluation
