Certain findings may serve as red flags of an underlying disorder causing a side-locked headache (secondary headache).
A side-locked headache is one that occurs > 90% of the time on one side of the head.
Secondary headaches:
(1) often are persistent and progressive
(2) may be precipitated by a provocative maneuver
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Red Flag
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May Indicate
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fever
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temporal arteritis, malignancy, infection
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weight loss
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temporal arteritis, malignancy
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cough or chest symptoms
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lung cancer, infection
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nasal or sinus symptoms
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sinusitis
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ophthalmoplegia
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painful ophthalmoplegia syndrome
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visual disturbance
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glaucoma, ocular inflammation, optic neuritis, temporal arteritis, orbital lesion
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cognitive, motor, sensory or cerebellar abnormality
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intracranial lesion
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pain peaks within minutes of onset
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cervical artery dissection
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new onset after 50 years of age
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temporal arteritis, malignancy, glaucoma, cervicogenic headache
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papilledema
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intracranial lesion
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