Diagnostic Tests for Headache
Diagnostic Test list for Headache:
The list of diagnostic tests
mentioned in various sources as
used in the diagnosis of Headache
includes:
- Physical examination
- Blood pressure
- Temperature (if elevated must consider meningitis, but may be due to respiratory infection, sinusitis)
- Feel the temporal arteries, face and neck muscles, cervical spine, sinuses, teeth and temporomandibular joints
- Examine for neck stiffness which most commonly indicate meningitis or subarachnoid hemorrhage but may also indicate brain hemorrhage or cerebral abscess
- Examine for papilledema which may suggest cerebral abscess, brain hemorrhage or brain tumor
- Full neurological examination, including visual fields and visual acuity, pupils reaction to light, eye movements, sensation and motor power of face and limbs
- Mental state examination - including appearance, behavior, rate and continuity of speech, mood, affect, thought content, evidence of any hallucinations or abnormal beliefs, orientation to time, place and person, attention and concentration, short-term memory, insight and judgement.
- Blood tests
- Full blood count and ESR (anemia can cause headache; ESR is elevated in temporal arteritis; elevated white cell count may suggest bacterial infection)
- Blood sugar (low blood sugar in diabetics may cause headache)
- Thyroid function test (low thyroid function may cause headache)
- Syphilis serology, if indicated to rule out neurosyphilis
- Urine tests
- Radiological investigations
- Skull X-Ray, if suspect brain tumor, Paget's disease
- Sinus X-Ray, if suspected sinusitis
- CT Scan of brain, if suspected brain tumor, stroke, subarachnoid hemorrhage)
- Radioisotope brain scan, may be indicated to localize specific brain tumors and haematomas (blood clots)
- MRI scan of brain, may be necessary
- Chest X-Ray to look for lung cancer, if brain tumor is diagnosed (lung cancer is the most common cause of brain cancer)
- Cerebral angiography, may be required to rule out aneurysms and arteriovenous malformations
- Lumbar puncture, if suspect meningitis, benign intracranial hypertension or subarachnoid hemorrhage or neurosyphilis. Only perform if CT brain is normal as it could be dangerous if intracranial pressure is raised
- Biopsy of the superficial temporal artery - if suspect temporal arteritis.
- Blood tests
- Thyroid function tests
- CBC - for anemia.
- Head X-rays
- Head CT scan
- MRI scan
- EEG
- Angiogram
- Eye exam
Home Diagnostic Testing
These home medical tests may be relevant to Headache causes:
- Nerve Neuropathy: Related Home Testing:
Tests and diagnosis discussion for Headache:
Physicians will obtain a
full medical history and may order a blood test to screen for thyroid
disease, anemia, or infections or x-rays to rule out a brain tumor or
blood clots. CTs, MRIs, and EEGs may be recommended. An eye exam is
usually performed to check for weakness in the eye muscle or unequal pupil
size.
(Source: excerpt from NINDS Headache Information Page: NINDS)
Diagnosing a headache is like playing Twenty Questions. Experts agree
that a detailed question-and-answer session with a patient can often
produce enough information for a diagnosis. Many types of headaches have
clear-cut symptoms which fall into an easily recognizable pattern.
Patients may be asked: How often do you have headaches? Where is the
pain? How long do the headaches last? When did you first develop
headaches? The patient's sleep habits and family and work situations may
also be probed.
Most physicians will also obtain a full medical history from the
patient, inquiring about past head trauma or surgery, eye strain, sinus
problems, dental problems, difficulties with opening and closing of the
jaw, and the use of medications. This may be enough to suggest strongly
that the patient has migraine or cluster headaches. A complete and careful
physical and neurological examination will exclude many possibilities and
the suspicion of aneurysm, meningitis, or certain brain tumors. A blood
test may be ordered to screen for thyroid disease, anemia, or infections
which might cause a headache.
A test called an electroencephalogram (EEG) may be given to measure
brain activity. EEG's can indicate a malfunction in the brain, but they
cannot usually pinpoint a problem that might be causing a headache. A
physician may suggest that a patient with unusual headaches undergo a
computed tomographic (CT) scan and/or a magnetic resonance imaging (MRI)
scan. The scans enable the physician to distinguish, for example, between
a bleeding blood vessel in the brain and a brain tumor, and are important
diagnostic tools in cases of headache associated with brain lesions or
other serious disease. CT scans produce X-ray images of the brain that
show structures or variations in the density of different types of tissue.
MRI scans use magnetic fields and radio waves to produce an image that
provides information about the structure and biochemistry of the
brain.
If an aneurysm-an abnormal ballooning of a blood vessel-is suspected, a
physician may order a CT scan to examine for blood and then an angiogram.
In this test, a special fluid which can be seen on an X-ray is injected
into the patient and carried in the bloodstream to the brain to reveal any
abnormalities in the blood vessels there. (Source: excerpt from Headache - Hope Through Research: NINDS)
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