Secondary headaches

Characteristics

can occur after head trauma
chronic headache if occurs 3 months after head trauma
pervious h/o headache, family history are at higher risk of conversion into chronic migraine
can sometimes present with features of primary headaches like tension type, migraine or cervicogenic headaches
may require frequent analgesics - can sometime lead to medication overuse headache
can be complicated by headache relapses

over-diagnosed
headaches are recurrent and respond to analgesics then migraines should be suspected
in the absence of chronic cough, nasal discharge, fever - sinus headache should not be made

headache more than 15days / month for 3 months with h/o taking analgesics 15 days / month or prescription medication including triptans more than 10 days / month
if the patient is complaining of decreased effectiveness following medication, medication overuse headache should be suspected

can be caused by mass, or intrinsic increase in pressure
headache is caused by increased pressure on dura
idiopathic intracranial hypertension can be caused by increased ingestion of fat soluble vitamins like vitamin A, minocycline, hormonal changes, or blocked venous drainage due to causes like mastoiditis
MRA or MRV should be performed
if headache persist or visual changes present - carbonic anhydrase inhibitors, optic nerve fenestration or shunt need to be considered

arteriovenous malformation, berry aneurysms, collagen vascular diseases, hypertensive encephalopathy, infective etiology, subarachnoid hemorrhage