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Red Flag Sign or Symptom
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Underlying Process
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systemic symptoms including fever (S)
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infection, nonvascular intracranial disorder, neuroendocrine tumor
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history of neoplasm (N)
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primary or metastatic tumor
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neurologic deficit or dysfunction (N)
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intracranial disorder
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sudden or abrupt onset (O)
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subarachnoid hemorrhage, intracerebral vascular disorder
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older age (> 50 years, O)
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giant cell arteritis, vascular disorder, tumor
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change in pattern or recent onset (P)
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intracranial disorder
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positional (P)
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intracranial hypertension or hypotension
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precipitated by sneezing, coughing, or exercise (P)
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posterior fossa malformation, Chiari malformation
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papilledema (P)
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intracranial mass lesion, intracranial hypertension
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progressive and atypical presentation (P)
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intracranial disorder
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pregnancy or puerperium (P)
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post-dural puncture headache, eclampsia, cerebral sinus thrombosis, anemia, diabetes, hypothyroidism, cranial or cervical vascular disorder
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painful eye with autonomic features (P)
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pathology of posterior fossa, pituitary or cavernous sinus, Tolosa-Hunt syndrome, ophthalmologic cause
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post-traumatic onset (P)
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traumatic brain injury, subdural hemorrhage
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pathology of the immune system (P)
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opportunistic infection
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painkiller overuse or new drug at onset of headache (P)
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medication overuse; drug incompatibility
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