Headaches are a common ailment that most of us experience from time to time. But sometimes headaches can be a symptom of a more serious condition. It’s important to know the “red flags” that can indicate when a headache requires medical attention.
In this article, we’ll go through ten key points for spotting red flags and dangerous headaches, as well as a useful mnemonic called SNNOOP10.
Remember, these are general guidelines and it’s important to seek medical help if you’re concerned about your headaches.
It’s always better to be safe than sorry.
Red flags for headaches:
The SNNOP10 rule
S
Systemic Symptoms or Conditions
Look for signs such as fever, unexplained weight loss, or a history of cancer. These may suggest an infection, autoimmune disorder, or malignancy.
N
Neoplasm in history
Neoplasm of the brain, metastasis.
N
Neurological signs:
Paralysis, visual disturbances, speech difficulties, epileptic seizures, papilloedema can be signs of a number of conditions, including idiopathic intracranial hypertension, sinus vein thrombosis, infection, or a tumor.
O
Onset – Sudden or Severe (“Thunderclap”)
A headache that reaches maximum intensity within seconds to minutes can be a sign of a vascular event, such as an aneurysm rupture or other serious intracranial process.
O
Older:
Older than 50 years at the onset of headache may be a red flag for temporal arteritis, malignancy, or malignant hypertension.
P
10 P’s:
Ses list underneath:
P – Pattern Change or New Headache: A significant change in headache frequency, severity, or clinical features warrants further evaluation.
P – Positional Headache: Headaches that worsen or improve with changes in posture may suggest intracranial hypotension or hypertension.
P – Precipitated by Valsalva Maneuver: Headaches triggered by actions like coughing, sneezing, or exercise can be associated with Chiari malformation.
P – Papilledema: Swelling of the optic disc indicates increased intracranial pressure, necessitating immediate investigation.
P – Progressive Headache or Atypical Presentation: Headaches that are worsening over time or have unusual features may suggest a secondary cause.
P – Pregnancy or Puerperium: Headaches during or shortly after pregnancy can be linked to conditions like eclampsia or cerebral venous thrombosis.
P – Painful Eye with Autonomic Features: Severe eye pain accompanied by symptoms like tearing or redness may indicate conditions such as acute angle-closure glaucoma or cluster headache.
P – Post-Traumatic Onset: Headaches developing after head injury could signify concussion, subdural hematoma, or other trauma-related issues.ppemedical.com
P – Pathology of the Immune System: Individuals with compromised immune systems, such as those with HIV, may experience headaches due to opportunistic infections or malignancies.
P – Painkiller Overuse or New Drug at Onset: Overuse of analgesics can lead to medication-overuse headaches, and new medications might have headache as a side effect.
Recognizing these warning signs is essential for the timely diagnosis and management of secondary headaches. Healthcare providers should maintain a high index of suspicion when these red flags are present and pursue appropriate diagnostic evaluations to rule out serious underlying conditions.
For a comprehensive overview, refer to the article: Red and orange flags for secondary headaches in clinical practice: SNNOOP10 list.
Remember: Call your local hospital and emergency department if you believe urgent evaluation is indicated, and if you are unsure.
1
Sudden and severe headache:
May indicate aneurysm or cerebral hemorrhage.
2
Headache with fever, stiff neck or confusion:
May indicate meningitis or other infection.
3
Headache that is aggravated by exertion, coughing or bending forward:
May be a sign of increased pressure in the head.
4
Persistent headaches that do not respond to painkillers:
May indicate an underlying chronic condition.
5
Changes in vision, speech or ability to move:
May be a sign of a neurological problem.
6
Sudden onset of “thunderclap” headache:
May be a sign of an aneurysm.
7
New or unusual neurological symptoms:
Weakness, numbness, visual changes may indicate secondary headaches.
8
Headache with fever, stiff neck, cramps, fainting or confusion:
May be a sign of a life-threatening condition.
9
Headache after head injury:
Requires immediate medical attention.
10
Headache with visual changes:
Could be a red flag.
