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Abstract
Headache is a symptom with various causes. In some disorders, headache is associated with focal neurological signs or symptoms. This may be a primary headache (eg, migraine) or secondary headache to an underlying infectious, inflammatory, vascular, neoplastic, or epileptic disorder.
Although patients are often quite concerned that their headaches represent serious underlying illness, most headache syndromes have a benign prognosis. For example, although most patients who believe their headaches are due to an ominous cause suspect that they have a brain tumor, the overall incidence of headache of a central nervous system neoplasm is less than 9 per 100,000.2
A large number of patients present with many chronic problems or complaints, and often minimize their headache or mention it only as the visit draws to a close. Attempting to make an accurate diagnosis in a limited amount of time is often a source of consternation, for one does not wish to overlook a potentially life-threatening cause of the headache, yet a cost-effective approach to evaluating what usually represents a benign disorder precludes the routine use of laboratory tests and neuroimaging modalities.