Diagnosis and management of headache in adults: summary of SIGN guideline

In stable migraine only 0.2% have relevant abnormalities on neuroimaging. 15 Both magnetic resonance imaging and computed tomography can identify incidental abnormalities that may result in patient anxiety as well as dilemmas in practical and ethical management. 16 17 The following are warning signs...

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Bibliographic Details
Published in:BMJ 2008-11, Vol.337 (nov20 1), p.a2329-a2329
Main Authors: Duncan, C W, Watson, D P B, Stein, A
Format: Article
Language:English
Subjects:
Acupuncture
Adult
Analgesics
Brain research
Chronic Disease
Complementary Therapies
Contraceptive Agents - adverse effects
Diagnosis
Diaries
Disease management
Education
Female
Headache Disorders - diagnosis
Headache Disorders - etiology
Headache Disorders - therapy
Headaches
Health professionals
Hormones - physiology
Humans
Life Style
Medical History Taking
Medical imaging
Meningitis
Migraine
Neurology
NMR
Nuclear magnetic resonance
Patients
Physical Examination
Physicians
Practice Guidelines as Topic
Pregnancy
Pregnancy Complications - diagnosis
Pregnancy Complications - etiology
Pregnancy Complications - therapy
Prevalence
Psychotherapy - methods
Signs
Citations: Items that cite this one
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Summary:In stable migraine only 0.2% have relevant abnormalities on neuroimaging. 15 Both magnetic resonance imaging and computed tomography can identify incidental abnormalities that may result in patient anxiety as well as dilemmas in practical and ethical management. 16 17 The following are warning signs or "red flags" for potential secondary headache, based on observational studies (D): new headache in a patient aged over 50; thunderclap onset (that is, abrupt and severe); focal and non-focal symptoms; abnormal signs; headache changing with posture; valsalva headache (headache triggered by valsalva-type manoeuvres such as coughing, sneezing, bending, heavy lifting, straining); fever; history of HIV; or cancer. Future research and remaining uncertainties The Guideline Development Group identified the following areas for further research: A UK based study evaluating the effectiveness of headache education for general practitioners to improve diagnosis, management, and referral to secondary care for patients with headache A comparison of acute versus gradual withdrawal of overused medications in medication overuse headache to determine the best management strategy for primary care An evaluation of the effectiveness of headache diaries by general practitioners in routine clinical practice in improving diagnostic accuracy of headache types.
ISSN:0959-8138
0959-535X
1468-5833
1756-1833
DOI:10.1136/bmj.a2329