Red Flag Symptoms

Certain features of the presentation may be regarded as ‘red flags’.

These significantly increase the risk that there is a secondary cause for the headache and, therefore, further investigation is warranted.

These are:

• Headache in someone >50 years
• Thunderclap headache (headache reaching maximum intensity within 60 seconds of onset)
• Headaches increasing in severity and frequency
• Headache with fever, neck stiffness, or reduced level of consciousness
• Focal neurological symptoms or signs
• Papilloedema
• Headache after trauma
• Loos of vision/ amaurosis fugax
• Immunocompromised, Malignancy

Learning bite

The presence of any ‘red flag’ feature mandates further investigation of a patient presenting with headache.