Phaeochromocytoma [top]

  • Episodic
  • Anxiety
  • Sweating
  • Hypertension
  • Headache
  • Shortness of breath
  • Rare
  • Episodes of Sweating, Palpitations, Tachycardia
  • Nausea, vomiting
  • Headache
  • Hypertension

Low pressure headache [top]

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

Food poisoning: Salmonella typhi [top]

  • Acute episode diarrhoea, fever, vomiting
  • Abdominal cramps, headache
  • Undercooked poultry / eggs

Meningitis [top]

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

Severe hypertension [top]

  • Headache
  • Vomiting
  • Visual disturbance

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

Raised intracranial pressure [top]

  • Subacute headache, particularly in the morning
  • May have associatednausea, vomiting
  • Precipitated by coughing and leaning forward
  • Associated papilloedema

Medication-induced headache [top]

  • Chronic headache
  • History of relevant drug e.g. nitrates
  • Can develop rebound headache due to long term usage of paracetamol, codeine or NSAIDs

Encephalitis [top]

  • Subacute headache
  • Confusion, fever, neurological deficit
  • May be reduced level of consciousness

Head injury [top]

  • Acute headache
  • History of trauma

Giant cell arteritis [top]

  • Subacute headache chronic headache
  • Aching pain over temple, worse on brushing hair
  • Associated with polymyalgia rheumatica: Proximal muscle pain and stiffness
  • Risk of sudden loss of vision due to ophthalmic artery occlusion
  • Elevated ESR

Sinusitis [top]

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

Subdural haematoma [top]

  • Subacute or chronic neurological deficit subacute neurological deficit chronic neurological deficit
  • Fluctuating neurological signs, confusion
  • Headache, Signs of raised intracranial pressure
  • Preceding history of head injury, may be minor trauma
  • Risk factors: Anticoagulant therapy, Elderly, Alcoholics

Intracranial haemorrhage [top]

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

Hyperprolactinaemia [top]

  • Amenorrhoea
  • Galactorrhoea
  • Headache with bitemporal hemianopia due to pituitary mass

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

Cervicogenic headache [top]

  • Chronic hemicranial pain referred from neck chronic headache
  • Worse on neck movment
  • Cervical X ray may show degenerative change

Tension headache [top]

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

Visual strain [top]

  • Chronic headache
  • Due to refractive error, worse after reading

Acute glaucoma [top]

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