Table 4 Red flag signs pertinent with side-locked headaches
Mnemonic (SNOOP4) [17] | Clinical descriptions | Secondary headaches |
|---|---|---|
Systemic | Fever | Temporal Arteritis (TA), malignancy, infective pathology (sinus, eye, teeth, etc.) |
Weight loss | TA, malignancy, | |
Cough and other chest symptoms | Carcinoma lung | |
Nasal symptoms | Sinus related headaches | |
Neurological | Opthalmoplegia (diplopia, ocular palsies) | Painful opthalmoplegia syndrome |
Visual disturbances | Ocular (glaucoma, post sclertitis, other inflammatory pathologies), Optic Nerve (optic neuritis, TA), orbital causes. | |
cognitive, motor, sensory or cerebellar abnormality | Intracranial pathologies | |
Onset sudden | Peak within minutes | Cervical artery dissection |
Onset after 50Â years | New headache in elderly | TA, Malignancy, Glaucoma (after 40Â years, acute or intermittent), cervicogenic headache |
Pattern of headaches | Persistent & progressive | A large number of secondary headaches have persistent & progressive course |
Pain other than head (i.e. headache with pain in eye, face, and neck) | Look for the pathologies at the site of maximum pain | |
Precipitated by provocative maneuvers | Referred to Fig. 4 | |
papilledema | Intracranial pathologies |