The full extent of the problem may not be understood immediately, but may be revealed with a comprehensive medical evaluation and diagnostic testing. The diagnosis of a headache is made with a careful history, physical examination and diagnostic tests.
Questions commonly asked during the exam may include, but are not limited to, the following:
- When do headaches occur?
- What is the location of the headache?
- What do the headaches feel like?
- How long do the headaches last?
- Have there been changes in behavior or personality?
- Do changes in position or sitting up cause the headache?
- Do you have trouble sleeping?
- Do you have a history of stress?
- Is there a history of head injury?
If the history is consistent with migraine or tension-type headaches and the neurological exam is normal, no further diagnostic testing may be necessary. However, if it is not a primary type headache, then other tests may be needed to determine the cause.
Tests used to determine the cause of a headache may include:
- Blood Tests - various blood chemistry and other laboratory tests may be run to check for underlying conditions.
- Sinus X-rays - a diagnostic imaging procedure to evaluate for congestion or other problems that may be corrected.
- Magnetic Resonance Imaging (MRI) - a diagnostic procedure that uses a combination of large magnets, radiofrequencies and a computer to produce detailed images of organs and structures within the body.
- Computed Tomography Scan (CT or CAT scan) - a diagnostic imaging procedure that uses a combination of x-rays and computer technology to produce cross-sectional images (often called slices), both horizontally and vertically, of the body. A CT scan shows detailed images of any part of the body, including the bones, muscles, fat and organs. CT scans are more detailed than general x-rays.
