neurologic disorders
Approach to the Patient With Headache
Key Points
Recurrent headaches that began at a young age in patients with a normal examination are usually benign. Neuroimaging is recommended as soon as possible for patients with altered mental status, seizures, papilledema, focal neurologic deficits, or thunderclap headache. CSF analysis is required after neuroimaging for patients with meningismus and usually for immunosuppressed patients and those with papilledema. Patients with thunderclap headache require CSF analysis even if neuroimaging and examination findings are normal as long as lumbar puncture is not contraindicated by imaging results. 