Table 1 Tests recommended for primary headache disorders

1

Migraine

1.1

Migraine without aura

None

Frequent episodic migraine

Brain MRI^a

Carodit ultrasound or MRA^a

ESR^a

1.2

Migraine with aura

Brain MRI^a

1.2.2

Migraine with brainstem aura

Brain MRI & MRA

EEG^a

Carotid and vertebral arteries ultrasound/or CT or MRA^a

Genetic evaluation^a

1.3

Chronic migraine

Brain MRI Gd & MRV^a

Fundoscopy^a

Lumbar puncture^a

Polysomnography^a

1.4

Complications of migraine

Brain MRI

1.4.1/2

Persistence of aura symptoms

Emergency brain CT or MRI

Carotid and vertebral arteries ultrasound/or CT or MRA

ESR^a

1.4.3

Migrainous infarction

Emergency brain CT or MRI

Carotid and vertebral arteries ultrasound/or CT or MRA^a

ESR^a

1.4.3

Migraine aura-triggered seizures

Repetitive EEGs or video EEG

1.5

Probable migraine

Brain MRI^a

1.6

Episodic syndromes that may be associated with migraine

Gastric work-up

2

TTH

2.1

Infrequent TTH

None

2.2 and 3

Frequent TTH and Chronic TTH

Brain MRI MRI Gd & MRV^a

Fundoscopy^a

Lumbar puncture^a

Polysomnography^a

3

TACs (all)

Brain MRI

Brain MRA and Carotid and vertebral arteries ultrasound/or CT or MRA^a

Pituitary function testing^a

3.1

Cluster headache

+Polysomnography^a

3.2

Paraxysmal Hemicrania

Brain MRI and MRA and Carotid and vertebral arteries ultrasound/or CT or MRA^a

3.3

Suna & Sunct

+ High resolution MRI of brainstem

3.4

Hemicrania Continua

Brain MRI

Brain MRA and Carotid and vertebral arteries ultrasound/or CT or MRA^a

4

Other primary headache disorders

4.1

Primary cough headache

Brain MRI

Cranio-cervical and brain MRA^a

4.2

Primary exercise headache

Brain MRI and MRA/MRV

Lumbar puncture^a

Carotid & vertebral ultrasound, or CT or MRA

Cardiological evaluation ^a

4.3

Primary headache associated with sexual activity

Brain MRI, MRA/MRV

Carotid and vertebral arteries ultrasound/or CT or MRA

Lumbar puncture^a

ESR, CRP^a

4.4

Primary thunderclap headache

Brain MRI, MRA/MRV

Carotid and vertebral arteries ultrasound/or CT or MRA

Lumbar puncture^a

ESR, CRP^a

4.5

Cold-stimulus headache

None

4.6

External-pressure headache

None

4.7

Primary stabbing headache

Brain MRI, MRA/MRV

Carotid and vertebral arteries ultrasound/or CT or MRA

Lumbar puncture^a

ESR, CRP^a

4.8

Nummular headache

Brain MRI, ESR, ANF and RF

4.9

Hypnic headache

Brain MRI, ESR, CRP

Polysomnography

24-hour blood pressure monitoring

4.10

New daily persistent headache

Brain MRI, MRA

Lumbar puncture^a