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- Symptoms/signs that suggest serious underlying conditions causing headaches are summarized by the mnemonic SNOOP:
- S - Systemic symptoms/signs/disease
- e.g. fever, weight loss, HIV, malignancy, pregnancy
- N - Neurologic symptoms/signs
- e.g. altered mental status, diplopia, pulsatile tinnitus, loss of consciousness
- O - Onset sudden, abrupt, thunderclap
- i.e. pain reaches maximal intensity instantly after onset
- O - Older age of onset, especially > 50 years
- P - Pattern change
- e.g. change in frequency, severity, clinical features, precipitated by Valsalva, aggravated by postural change
- S - Systemic symptoms/signs/disease
- Consider structural pathologies, vascular disorders, infectious and inflammatory conditions in the evaluation of secondary headache syndromes.
References
- Chou DE. Secondary headache syndromes. Continuum (Minneap Minn) 2018;24(4, Headache):1179-91.
- Doric DW. Pearls: headache. Semin Neurol 2010;30(1):74-81.
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