How are secondary headaches diagnosed?
If there is time, the diagnosis of secondary headache begins with a complete patient history followed by a physical examination and laboratory and radiology tests as appropriate.
However, some patients present in crisis with a decreased level of consciousness or unstable vital signs. In these situations, the health care professional may decide to treat a specific cause without waiting for tests to confirm the diagnosis.
For example, a patient with headache, fever, stiff neck, and confusion may have symptoms that suggest meningitis. Since meningitis can be rapidly fatal, antibiotic therapy may be started before blood tests and a lumbar puncture are performed to confirm the diagnosis. It may be that the diagnosis is found to be a brain tumor or subarachnoid hemorrhage, but the benefit of early antibiotics outweighs the risk of not giving them promptly.