Are there worrisome features (SNOOP)?10 |
| Systemic symptoms or illness (especially fever, change in mentation, anticoagulation, current or recent pregnancy, or cancer) |
| Neurologic symptoms or signs (papilledema, asymmetric cranial nerve or motor function, or abnormal cerebellar function) |
| Onset is recent or sudden |
| Onset after 40 years of age |
| Previous headache history is different or progressive |
What is the primary headache type? (Determine original headache pattern and any changes over time) |
| Duration longer than four hours |
| | Migraine features: chronic (transformed) migraine |
| | Lacking migraine features: chronic tension-type headache |
| | Abrupt onset headache pattern: new daily persistent headache |
| | Strictly unilateral: hemicrania continua |
| Duration shorter than four hours |
| | Strictly unilateral/autonomic features: indomethacin-responsive headaches |
| | Unilateral or bilateral/no associated autonomic features |
Evidence of medication overuse (including nonprescription drugs and caffeine) |
Evidence for underlying physical factors |
| Myofascial factors |
| | Cervical |
| | Temporomandibular |
| | Fibromyalgia |
| | Other chronic pain |
| Sinus symptoms |
| Sleep disturbance |
Evidence for psychiatric comorbidity |
| Depressive disorders |
| Anxiety disorders |
| Chemical dependency |
| Personality disorders |