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Diagnosis of Headache

You will be asked about your symptoms and health history. A physical exam will be done. The cause of a headache can be hard to find out. The doctor will ask about how often you get headaches and if they come in a pattern. Keep a diary of:

  • When your headaches start and end
  • What you were doing at the time
  • What you did to try to ease pain and if it worked
  • Family members with the same problem
  • Triggers that you know of
  • Where the pain is and where it spreads to
  • Other symptoms that you have with the pain

Tests to find out the cause are:

  • Neurological exam to check:
    • Muscle strength
    • Coordination
    • Reflexes
    • Sensation
    • Mental status
    • Cranial nerve function
  • Lumbar puncture —Spinal fluid is collected to look for bleeding, infections, or cancer. The pressure may also be measured.

Images are done to check internal structures for problems. Some tests may use contrast material to make the images easier to see. These may be:

  • X-rays .
  • CT scan
  • MRI scan
  • Nasal endoscopy —A thin, lighted tube with a camera is placed in the nose. If needed, tissue samples can be taken and tested.

Cluster headache. EBSCO DynaMed Plus website. Available at: Updated March 20, 2018. Accessed December 19, 2018.

Headache Classification Committee of the International Headache Society (IHS) The International Classification of Headache Disorders, 3rd edition. Cephalalgia. 2018 Jan;38(1):1-211.

Headache—frequently asked questions. National Headache Foundation website. Available at: Accessed January 11, 2019.

Migraine in adults. EBSCO DynaMed Plus website. Available at: Updated November 8, 2018. Accessed December 19, 2018.

NINDS headache information page. National Institute of Neurological Disorders and Stroke website. Available at: Accessed December 19, 2018.

Tension-type headache. EBSCO DynaMed website. Available at: Updated March 20, 2018. Accessed December 19, 2018.

Last reviewed December 2018 by EBSCO Medical Review Board Rimas Lukas, MD