How is headache diagnosed?

    The first step in diagnosing headache is taking a thorough history, which will include questions about previous head trauma or surgery, and use of medications. This is followed by testing reflexes, sensation, equilibrium, strength, agility as well as assessing speech, and a brief psychological exam. It’s important to emphasize again that the majority of headache stems from benign causes.

    Lab work can be ordered as needed to screen for thyroid disease, anemia, or infections. A clinical exam will follow. This will consist of blood tests (complete blood count); urinalysis – various substances like salts indicate whether a metabolic screening is in order.

    Imaging as needed will be performed (CT, MRI). X-rays may be taken to rule out the possibility of a brain tumor or blood clot. The CT scan produces images of the brain that show variations in the density of different types of tissue. The scan enables the physician to distinguish, for example, between a bleeding blood vessel in the brain and a brain tumor. The CT scan is an important diagnostic tool in cases of headache associated with brain lesions or other serious diseases.

    An eye exam checks for weakness in the eye muscle or unequal pupil size. Both of these findings may be evidence of masses in the headaches aneurysm or tumors or something such as diabetes. If an aneurysm is suspected, an angiogram can be ordered. A special fluid visible on an X ray is injected into the patient . It is carried in the bloodstream to the brain to reveal any abnormalities in the blood vessels there.

    Thermography is an experimental technique for diagnosing headache of great promise. An infrared camera converts skin temperature into a color picture or thermogram with different degrees of heat appearing as different colors. Skin temperature is affected primarily by blood flow. Thermograms of headache patients show strikingly different heat patterns from those of people who never or rarely get headaches.

    Electrical studies as needed: EEG, or brain wave testing can indicate can indicate a malfunction in the brain; an EMG is a study of muscle function.