Abstract
Headache is one of the most common reasons for medical consultation, and it can classified into two categories: primary (without underlying structural cause to which to attribute the symptoms) that includes migraine with and without aura, chronic migraines, tension headaches, autonomic trigeminal, headaches due to cough, exercise, cold or sexual stimulation, and thunderclap headache; and secondary (there is an underlying cause that could threaten life) and includes those attributable to head and neck trauma, vascular injury, those caused by non-vascular intracranial pathologies, or psychiatric disorders. All headaches should be evaluated to exclude a secondary one. Subarachnoid hemorrhage, whose main cardinal sign is intense headache of sudden onset, is commonly misdiagnosed as migraine or tension-type headache and is associated with a high risk of death or severe disability, can present associated symptoms such as vomiting, altered consciousness, neck stiffness and neurological deficits. Bacterial meningitis has a high risk of complications with the potential to cause serious sequelae or death, it commonly presents with headache, nuchal rigidity, and fever, and less frequently, altered mental status, epileptic seizures, and focal signs. Intracranial hypertension (sustained elevation of intracranial pressure >20 mmHg for >5-10 minutes) has a clinical presentation of holocranial headache, papilledema, projectile vomiting, and altered mental status. Although all these pathologies have headache as a symptom in common, it is necessary to study them to guide a better differential diagnosis, since they all require a very different approach, but all of them urgent, to avoid complications.
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Copyright (c) 2022 Claudia Orozco Cubero, Luis Fernando Alfaro Guerra