Can be primary or secondary (precipitated by another condition)

History

• characteristic of pain including location and spread, severity, quality
• Onset, duration, frequency, pattern
• Associated Sx: nausea and vomitting, aura, photophobia, phonophobia (migraines)
• Autonomic Sx: lacrimation, conjunctival infection, rhinorrhoea (cluster headache)
• Pre-disposing triggers?
• Household contacts with similar Sx (CO poisoning)
• Co-morbidities - malignancy, immunosuppression
• Medication used for Sx relief
• impact on QOL
• RED FLAGS

Examination:

• vital signs, mental state, alertness, neuro exam, fundoscopy

Red flags

*Serious causes of headaches are rare, accounting for less than 1% of presentations

• Fever, photophobia or neck stiffness (meningitis or encephalitis)
• New neurological symptoms (haemorrhage, malignancy or stroke)