Diagnosing Your Headache: Headache Evaluation

Why is it Important to Diagnose a Headache?

The correct diagnosis is needed to begin an effective treatment plan. Early visits to your doctor are made to establish what type or classification of headache you have. Describe your headache symptoms and history as completely as possible.

History of Headache Treatments

A history of prior headache treatments is also an important part of the headache evaluation. Provide your doctor with a history of prior treatments — both prescribed and over-the-counter — for your headaches. Tell your doctor what medicines you have taken in the past and what medicines you are currently taking. Don't hesitate to list them, bring the bottles or ask your pharmacist for a printout.

Studies performed by other doctors, including X-rays and scans, are very important. Bring these to your appointment as well, since it might save time and the need to repeat the tests.

Physical and Neurological Examinations

After completing the headache history portion of the evaluation, the doctor will perform a complete physical and neurological examination. The doctor will look for signs and symptoms of an illness that might be causing the headaches.

Neurological tests focus on ruling out diseases that might also cause headaches. A structural disorder of the central nervous system might be suspected in the development of serious headaches.

Diagnostic Tests

Additional diagnostic tests might be needed to rule out other medical conditions. These tests are listed below. Keep in mind that laboratory tests are not helpful in diagnosing migraine, cluster or tension-type headaches.

• Blood Chemistry and Urinalysis.

  These tests are used to determine other medical conditions — including diabetes, thyroid problems and infections — that can cause headaches.

• Computed Tomography (CT scan).

  This is a test during which X-rays and computers are used to produce images of a cross-section of the body.

• Magnetic Resonance Imaging (MRI).

  This test produces very clear pictures, or images, of the brain without the use of X-rays. An MRI might be recommended if you are getting daily or almost daily headaches. It might also be recommended if a CT scan does not show definitive results.

• Sinus X-ray.

  Although the CT scan and MRI provide more details, your doctor might use this test if your symptoms seem to indicate sinus problems.

• EEG, or Electroencephalogram.

  An EEG, or electroencephalogram, is not a standard part of a headache evaluation.

• Ophthalmology Evaluation.

  An eye pressure test performed by an eye doctor (ophthalmologist) will rule out glaucoma or pressure on the optic nerve as causes of headaches.

• Lumbar Puncture or Spinal Tap.

  A lumbar puncture or spinal tap is the removal of spinal fluid from the spinal canal. This diagnostic procedure is only done to rule out conditions that might be affecting the brain and spinal cord.

Post-Test Conclusions

After evaluating the results of the headache history, physical examination, neurological and psychological examination, your doctor should be able to determine what type of headache you have, whether or not a serious problem is present, and whether additional tests are needed.