Alarm Signs and Symptoms in Headache Indicating Possible Serious Intracranial or Systemic Pathology

Is the patient complaining of headaches?

• the new onset of headache in a previously headache-free patient?

• a change in the usual pattern of headache (new pattern, intensity, frequency or type of headache)?

• a history of recent head trauma?

• the presence of unexplained fever?

• the presence of focal or nonfocal neurologic deficits?

• a change in personality?

• a change in mental status?

• the presence of severe pain described as being the worst ever experienced?

• headache triggered by exertion, coughing, sneezing, bending over or other activity?

• headache accompanied by signs of meningeal irritation (stiff neck, nausea, vomiting)?