Recurring head pain is not something you have to live around. A careful diagnosis is what separates a headache you manage from one that manages you.
Headache is the single most common reason patients are referred to a neurologist — and one of the most frequently mislabelled. A great many people who have been told for years that they have “sinus headaches” or “stress headaches” turn out to have migraine, which responds to an entirely different set of treatments.
Getting the diagnosis right matters because the treatments diverge sharply. Migraine with prominent nausea and light sensitivity calls for a different approach than cluster headache, which in turn is nothing like cervicogenic headache arising from the neck. We spend the first visit establishing which pattern you actually have.
We also look hard for medication-overuse headache — a common and reversible cause of daily head pain that develops when acute painkillers are taken more than a couple of days a week. Patients are often surprised to learn the treatment is part of the problem.
Call 911 for a headache that comes on like a thunderclap and peaks within seconds, or for any headache with fever and a stiff neck, confusion, weakness on one side, difficulty speaking, or a first-ever seizure. A new severe headache after age 50, or after a head injury, should be evaluated the same day.
“Most patients who come in for “just headaches” have gone years without a specific diagnosis. Naming the condition correctly is usually what finally changes the outcome.”