Headache – Clinical Anatomy

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Although headache can arise from intra-cranial structures, it is important to also consider important causes from any of the extra-cranial structures including the neck

Head Pathology

A review of systems will ensure you screen for these possibilities

Structure involved Suggestive Clinical features Clinical examples
Eye Red eye or visual disturbance e.g. Acute glaucoma, Scleritis
Sinus Frontal headache or facial pain that alters with head position
Percussion tenderness
e.g. Acute sinusitis
Teeth Temperature sensitivity of teeth
Percussion tenderness
Dental caries
Gum swelling
e.g. Dental abscess
TMJ Pain with chewing
Scalp Superficial tenderness or skin lesions (e.g. look carefully) e.g  Herpes Zoster. 
Neck Tenderness or reduced movement of neck e.g. Vertebral osteomyelitis
Ears Ear discharge, erythema or drum or canal e.g. otitis externa
Meninges Nuchal rigidity e.g. Meningitis, Sub-arachnoid haemorrhage



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