Clinical QuickieNeurology
Headache — Primary vs Secondary
The most important headache question is often: is this different from usual?
Classify the familiar patterns
Migraine, tension-type, and cluster headaches have recognizable features, but overlap occurs.
Screen for secondary red flags
Thunderclap onset, focal neurologic deficits, meningismus, papilledema, pregnancy/postpartum context, cancer/immunocompromise, trauma, or major pattern change require a different pathway.
Imaging is not automatic
Stable recurrent migraine with a normal neurologic exam and no red flags usually does not need routine imaging.
Watch for medication-overuse headache
Frequent acute-medication use can transform episodic headache into a more persistent problem.
Want more depth?
Read the Deep Dive