10.5061/DRYAD.DV5K7P2
Do, Thien Phu
University of Copenhagen
Remmers, Angelique
Department of Neurology, Elisabeth-TweeSteden Hospital, Tilburg, the
Netherlands
Schytz, Henrik Winther
University of Copenhagen
Schankin, Christoph
University Hospital of Bern
Nelson, Sarah E.
Johns Hopkins University
Obermann, Mark
University of Duisburg-Essen
Hansen, Jakob Møller
University of Copenhagen
Sinclair, Alexandra J.
University of Birmingham
Ganteinbein, Andreas R.
University of Zurich
Schoonman, Guus G.
Department of Neurology, Elisabeth-TweeSteden Hospital, Tilburg, the
Netherlands
Data from: Red and orange flags for secondary headaches in clinical
practice: SNNOOP10 list
Dryad
dataset
2019
2019-01-30T16:23:18Z
2019-01-30T16:23:18Z
en
https://doi.org/10.1212/WNL.0000000000006697
19458 bytes
1
CC0 1.0 Universal (CC0 1.0) Public Domain Dedication
A minority of headache patients have a secondary headache disorder. The
medical literature presents and promotes red flags to increase the
likelihood of identifying a secondary etiology. In this review, we aim to
discuss the incidence and prevalence of secondary headaches as well as the
data on sensitivity, specificity, and predictive value of red flags for
secondary headaches. We review the following red flags: (1) systemic
symptoms including fever; (2) neoplasm history; (3) neurologic deficit
(including decreased consciousness); (4) sudden or abrupt onset; (5) older
age (onset after 65 years); (6) pattern change or recent onset of new
headache; (7) positional headache; (8) precipitated by sneezing, coughing,
or exercise; (9) papilledema; (10) progressive headache and atypical
presentations; (11) pregnancy or puerperium; (12) painful eye with
autonomic features; (13) posttraumatic onset of headache; (14) pathology
of the immune system such as HIV; (15) painkiller overuse or new drug at
onset of headache. Using the systematic SNNOOP10 list to screen new
headache patients will presumably increase the likelihood of detecting a
secondary cause. The lack of prospective epidemiologic studies on red
flags and the low incidence of many secondary headaches leave many
questions unanswered and call for large prospective studies. A validated
screening tool could reduce unneeded neuroimaging and costs.
References 60-131References 60-131dryad_new.docx