Learning Centre

Red flags

A reminder list, not a diagnostic device

Sudden onset, peaking in under one minuteFever, weight loss, or the person looks illA new neurological sign: weakness, double vision, seizure, reduced consciousnessA new headache after age 50A clear change in an old patternPostural: worse upright or worse lying downWorse with cough, strain, or bendingPapilloedema on examinationPregnancy or the postpartum period with a new headacheCancer, immune compromise, or immunosuppressive drugsHeadache progressing over weeksA red painful eye, or new one-sided autonomic signsOnset immediately after head or neck injuryThe person calls it the worst headache of their life, and it was sudden

Absence of these items does not exclude serious disease. Clinical judgment stays in place.

History frame

No patient name is stored in this box. Copy the text into your own record.

Headache history
Age at onset / first attack sudden or gradual:
Current pattern (episodic, daily, progressive):
Length of each attack:
Site, quality, severity:
Nausea, light, sound, aura, autonomic signs:
Headache days per month / drug days per month:
Acute and preventive medicines:
Pregnancy, cancer, trauma, fever:
Neurological examination and fundi:

A reading path

1Start with the approachBefore a disease name, settle whether this is primary or secondary.2Then migraineThe common pattern mistaken for sinusitis and tension.3Then drug useIf headache has become daily, count the painkiller days.4CasesFour teaching histories with an answer and a point.

These pages are written for health professionals. They do not replace a history, examination, or clinical judgment. Treatment is decided for each patient individually.