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Tests and diagnosis
By Mayo Clinic staff
Brain imaging
Your doctor will likely recommend brain imaging.
- Magnetic resonance imaging (MRI). An MRI of the brain can help detect any underlying causes for your headache. During the MRI exam, a magnetic field and radio waves are used to create cross-sectional images of the structures within your brain.
- Computerized tomography (CT). In some cases, especially if your headache occurred less than 48 hours beforehand, a CT scan of your brain may be done. CT uses an X-ray unit that rotates around your body and a computer to create cross-sectional images of your brain and head.
Angiograms
Your doctor may also order a cerebral angiogram, a test that can show the neck and brain arteries. It involves threading a thin, flexible tube through a blood vessel, usually starting in the groin, to an artery in your neck. Contrast material is injected into the tube to allow an X-ray machine to create an image of the arteries in your neck and brain.
A less invasive version of this test uses MRI or CT instead of threading a catheter through your blood vessels.
Spinal tap
Sometimes a spinal tap (lumbar puncture) is needed as well — especially if the headache started abruptly and very recently and brain imaging is normal. With this procedure, the doctor removes a small amount of the fluid that surrounds your brain and spinal cord. The fluid sample can show if there's bleeding or infection.
- F Longo DL, et al. Harrison's Online. 18th ed. New York, N.Y.: The McGraw-Hill Companies; 2012. http://www.accessmedicine.com/resourceTOC.aspx?resourceID=4. Accessed Jan. 31, 2012.
- Headache: Hope through research. National Institute of Neurological Disorders and Stroke. http://www.ninds.nih.gov/disorders/headache/detail_headache.htm#142883138. Accessed Jan. 31, 2012.
- Preorgasmic headache. International Headache Society. http://ihs-classification.org/en/02_klassifikation/02_teil1/04.04.01_other.html. Accessed Jan. 31, 2012.
- Orgasmic headache. International Headache Society. http://ihs-classification.org/en/02_klassifikation/02_teil1/04.04.02_other.html. Accessed Jan. 31, 2012.
- Lange SE. Primary headache disorders in the emergency department. Advanced Emergency Nursing Journal. 2011;33:237.
- Wong WS, et al. The ''other'' headaches: Primary cough, exertion, sex and primary stabbing headaches. Current Pain and Headache Reports. 2010;14:41.
- Pascual J, et al. Orgasmic headaches: Clinical features, diagnosis and management. Headache. 2000;40:491.
- Pascual J. Other primary headaches. Neurologic Clinics. 2009;27:557.
- Bartleson JD (expert opinion). Mayo Clinic, Rochester, Minn. Feb. 14, 2012.
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