Headache is an unpleasant physical sensation in any region of the head.



Where is the pain?
Is the pain on both sides of the head?
Is there is pain anywhere else on the body?


What is the pain like?


How bad is the headache on a scale of 0 to 10?
Is it the worst headache you have ever had?
What is it preventing you from doing?

Time Course


Did it start suddenly?


How long have you been having headaches for?
How long does a headache last for?

Temporal Profile

Has it been getting worse? Has it been getting more frequent?
Is the headache there all the time?
Are the headaches worse at a certain time of day?
Have you had this problem before?


Can you think of anything that may have caused the headache?
Have you been in contact with anybody who has had Meningitis recently?
Are you:
  • Currently stresssed
  • Sleep Deprived
  • Pregnant

Prodrome (Migraine)

Do you notice anything before a headache?

Aggravating Factors

Does anything make it worse?
Is the pain worse on exertion?
Is the pain worse when standing up?

Relieving Factors

Does anything make it better?

Associated Features

Past History

Have you ever had:
  • Headaches
  • Head Trauma
  • Immune Compromise
  • Cancer


Have there been any changes in your medications?
Have you recently stopped taking:

Family History

Has anybody in your family ever had:

Social History

Can you tell me about you where you live?
Where were you born?
Where do you work?
What are your hobbies?
Do you smoke?
Do you drink?

Do you use any recreational drugs?

Examinations and Investigations



  • MRI brain
  • CT brain

Indications for Brain Imaging

  • Focal neurologic signs or symptoms
  • Onset of headache with exertion
  • Orbital bruit
  • Onset of headache after age 40 years
  • Increase in frequency or severity of headache


  • Lumbar Puncture

Differential Diagnosis




Women's Health


Red Flags


  • Analgesics (Paracetemol or NSAIDs)
  • Fluids
  • Rest
  • Disease-specific treatments
  • Referral to Neurology, Neurosurgery, Infectious Diseases, Ophthalmologist, Obstetrician

See also

Assessment of Acute Headache in adults
UpToDate-Headache causes and diagnosis in adults