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
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 |