Sinusitis [top]

  • Acute headache may be recurrent
  • Facial pain and tenderness, particularly over frontal and maxillary sinuses, fever
  • Preceding URTI with nasal discharge

Cerebellar stroke [top]

  • Sudden onset of vertigo, headache acute headache, vomiting and ataxia
  • May be complicated by loss of consciousness, brainstem signs or hydrocephalus

Low pressure headache [top]

  • Acute headache
  • Follows lumbar puncture
  • Worsened by sitting upright, resolves spontaneously

Subarachnoid haemorrhage [top]

  • Acute headache, very sudden onset 'like being kicked in the back of the head'
  • May be drowsy / unconscious loss of consciousness, vomiting
  • Signs of meningism:neck stiffness, photophobia
  • Acute neurological deficit

Meningitis [top]

  • Acute headache
  • Photophobia, neck stiffness, meningism, Kernig's sign positive
  • Fever, vomiting, seizure
  • Non-blanching purpuric rash with bacterial meningitis

Migraine [top]

  • Acute headache usually with previous similar episodes
  • Typically unilateral and described as pulsating
  • Often preceded by visual, auditory or other aura
  • May be severe with associated nausea, vomiting, photophobia, vertigo
  • May cause transient neurological deficit

Cluster headache [top]

  • Typically recurrent daily attacks for a number of weeks then a period of remission acute headache chronic headache
  • Unilateral orbital, supraorbital or temporal burning / boring pain duration several hours
  • Often described as the most severe pain ever experienced

Head injury [top]

  • Acute headache
  • History of trauma

Intracranial haemorrhage [top]

  • Acute neurological deficit: dysphasia, hemiparesis, hemianopia
  • Acute headache, vomiting
  • History of anticoagulant therapy or bleeding diathesis

Acute glaucoma [top]

  • Acute headache
  • Unilateral red eye, Reduced visual acuity
  • Appearance of halos around lights vomiting

Tension headache [top]

  • Acute or chronic, acute headache chronic headache may be recurrent
  • Sensation of tightness, constricting band
  • Associated with psychological stress