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Semin Neurol 2022; 42(04): 418-427
DOI: 10.1055/s-0042-1757753
Review Article

Secondary Headache Disorders: Approach, Workup, and Special Considerations for Select Populations

Sarah A. Friedman 
1   Department of Neurology, Weill Cornell Medicine and New York Presbyterian, New York, New York
,
Alina Masters-Israilov
1   Department of Neurology, Weill Cornell Medicine and New York Presbyterian, New York, New York
,
Matthew S. Robbins
1   Department of Neurology, Weill Cornell Medicine and New York Presbyterian, New York, New York
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Abstract

Headache is one of the most common diagnoses in neurology. A thorough understanding of the clinical presentation of secondary headache, which can be life-threatening, is critical. This review provides an overview of the diagnostic approach to a patient with headache, including discussion of “red,” “orange,” and “green” flags. We emphasize particular scenarios to help tailor the clinical workup to individual circumstances such as in pregnant women, when particular attention must be paid to the effects of blood pressure and hypercoagulability, as well as in older adults, where there is a need for higher suspicion for an intracranial mass lesion or giant cell arteritis. Patients with risk factors for headache secondary to alterations in intracranial pressure, whether elevated (e.g., idiopathic intracranial hypertension) or decreased (e.g., cerebrospinal fluid leak), may require more specific diagnostic testing and treatment. Finally, headache in patients with COVID-19 or long COVID-19 is increasingly recognized and may have multiple etiologies.

Keywords

secondary headache - idiopathic intracranial hypertension - CSF leaks - Elderly patients - pregnancy - COVID-19 - long COVID-19


Publication History

Article published online:
11 October 2022

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