Assessment of acute headache in adults

Last reviewed: 20 May 2025
Last updated: 03 Jul 2024

Summary

Differentials

Common

  • Tension headache
  • Migraine
  • Acute sinusitis
  • Otitis media
  • Menstrual headache
  • Medication withdrawal
  • Medication overuse headache
  • Cervical paraspinal muscle tenderness
  • Dental caries/wisdom tooth impaction
  • Temporomandibular disorders
  • Acute hydrocephalus
Full details

Uncommon

  • idiopathic intracranial hypertension (pseudotumor cerebri)
  • Brain tumour
  • Hypertensive encephalopathy
  • Eclampsia/pre-eclampsia
  • Pituitary apoplexy
  • Venous sinus thrombosis
  • Epidural haematoma
  • Subarachnoid haemorrhage (SAH)
  • Subdural haematoma
  • Meningitis
  • Brain abscess
  • Carbon monoxide poisoning
  • Concussive syndrome/trauma
  • Acute mountain sickness/hypoxia
  • Cluster headaches
  • Paroxysmal hemicrania
  • Trigeminal neuralgia
  • Acute angle-closure glaucoma
  • Giant cell arteritis
  • Zika virus infection
  • Chikungunya
  • Dengue fever
  • Stroke
Full details

Contributors

Authors

Meika T. Neblett, MD, MS

Associate Director

Department of Emergency Medicine

Saint Lukes Cornwall Hospital

Newburgh

NY

Disclosures

MTN declares that she has no competing interests.

Peer reviewers

Shuhan Zhu, MD

Member of the Faculty

Brigham Women's Hospital

Boston

MA

Disclosures

SZ declares that she has no competing interests.

Paul Hamilton, MD

Director

Department of Emergency Medicine

Mount Sinai School of Medicine

New York

NY

Disclosures

PH declares that he has no competing interests.

Sheldon Jacobson, MD, FACP, FACEP

Chairman

Department of Emergency Medicine

Mount Sinai School of Medicine

New York

NY

Disclosures

SJ declares that he has no competing interests.

Eirik Helseth, MD, PhD

Senior Neurosurgeon

Oslo University Hospital

Professor

University of Oslo

Oslo

Norway

Disclosures

EH declares that he has no competing interests.

References

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Key articles

American College of Radiology. ACR appropriateness criteria®: headache. 2022 [internet publication].Full text  Abstract

National Institute for Health and Care Excellence. Headaches in over 12s: diagnosis and management. Dec 2021 [internet publication].Full text

Headache Classification Committee of the International Headache Society (IHS). The international classification of headache disorders, 3rd edition. Cephalalgia. 2018 Jan;38(1):1-211.Full text

Reference articles

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
  • Guidelines

    • ACR appropriateness criteria: headache
    • Headaches in over 12s: diagnosis and management
    More Guidelines
  • Patient information

    Migraine

    Meningitis and septicaemia

    More Patient information
  • Videos

    Diagnostic lumbar puncture in adults: animated demonstration

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