Headache is a common chief complaint in acute settings. The diagnosis of acute headache can be challenging and should proceed in an orderly fashion. An important first step is to distinguish primary from secondary headaches. The approach is to seek “red flags” that suggest the possibility of secondary headache. If one of these features is identified, the physician must conduct the workup indcated by the red flag and, thereby, diagnose any secondary headache disorder that is present. In the absence of secondary headache, the clinician proceeds to diagnosing a primary headache disorder.
In this article, Dr. Stephanie Nahas of Thomas Jefferson University follows this approach to discuss the differential diagnosis of acute headaches.
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