Signs and Symptoms Associated With Different Headache Etiologies

 • Nonfocal mental status changes - Meningitis, encephalitis, SAH, subdural hematoma, anoxia, increased intracranial pressure, carbon monoxide poisoning

 • Mental status changes with focal findings - Intraparenchymal bleed, tentorial herniation, stroke

 • Severe nausea, vomiting - Increased intracranial pressure, acute-angle closure glaucoma, SAH, carbon monoxide poisoning

 • Hypertension with normal heart rate or bradycardia - Increased intracranial pressure, SAH, tentorial herniation, intraparenchymal bleed, preeclampsia, reversible cerebral vasoconstriction syndrome

 • Tachycardia - Anoxia, anemia, febrile headache, exertional or coital headache

 • Fever - Febrile headache, meningitis, encephalitis

 • Tender temporal arteries - Temporal arteritis

 • Increased intraocular pressure - Acute angle closure glaucoma

 • Loss of venous pulsations on funduscopy or papilledema - Increased intracranial pressure, mass lesions, subhyaloid hemorrhage, SAH, cerebral venous thrombosis

 • Acute red eye (severe ciliary flushing) and poorly reactive pupils - Acute angle closure glaucoma

 • Enlarged pupil with third nerve palsy - Tentorial pressure cone, mass effect (aneurysm, bleed, abscess, or tumor)

 • Lateralized motor or sensory deficit - Stroke, subdural hematoma, epidural hematoma, hemiplegic or anesthetic migraine (rare), reversible cerebral vasoconstriction syndrome, central venous thrombosis

 • Balance and coordination deficits - Cervical artery dissection, acute cerebellar hemorrhage, acute cerebellitis (mostly children), chemical intoxication of various types

 • Extraocular movement deficits (CN Ill, IV, and VI) - Mass lesion, neurapraxia (post-traumatic headache), IIH



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