The most critical element in headache evaluation is the history. The targeted history differentiates primary from secondary headaches and provides a realistic list of conditions associated with secondary headache. Several of these conditions present with specific physical findings, such as papilledema, Horner's syndrome, or a cranial nerve palsy. The targeted physical examination of the patient with headache takes less than 3 minutes. The ability to recognize a few straightforward clinical findings directs the evaluation in the proper direction.
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