Peer review: Headaches - from simple to sinister

Headache and migraine presentations can be a challenge for both the patient and the practitioner. Trying to assess if there is an ocular cause is the primary objective. Reassuring the patient that what they have is within the normal parameters of headaches and migraines or directing them to their local GP for further assessment is the typical standard of care. However there are times when a sinister presentation presents in primary practice and practitioners need to be armed with the knowledge of how to differentiate the simple from the sinister sight-threatening and life-threatening conditions. Clinical pearls, red flags and best-practice strategies of how to prepare for these eventualities will be considered along with classification and features, referral criteria and social prescribing.

Learning outcome(s):

To improve the history taking of patients presenting with headaches, recognising the questions required to elicit relevant symptoms and to ensure appropriate outcomes (s.2)

To identify the signs and symptoms of patients presenting with headaches and to investigate and manage the patient appropriately and recognise common ocular causes of headaches and understand when referral is required, with the appropriate urgency (s.7).