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Diagnosis of Headaches

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 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?
  • Does you have trouble sleeping?
  • Does you have a history of stress?
  • Is there a history of recent 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 of headache, then other tests may be needed to determine the cause.

Tests used in the diagnosis of your 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 (Also called a 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.