The main reason would be if some other diagnosis is suspected. The patient’s symptoms or findings on the physical examination may suggest that there is a significant chance of finding another cause , other than migraine for the patient’s headache.

Are there other reasons to image the brains of people with migraine

These symptoms and signs on physical examination have been called red flags by some. The items listed below may suggest that further tests should be done beyond the physical examination. It is important to realize, however, that most of these are not absolute, and in many cases whether more tests should be done is a decision of medical judgment that your doctor will make based on all the facts of your case.

1. Abnormal findings on neurological examination, although this may not be true if there is another obvious cause for the finding.

2. Other neurological symptoms, for example epileptic seizures.

3. A headache attack which has a very sudden onset and which progresses to severe pain very quickly over seconds.

4. Headache symptoms which do not quite fit the usual primary headache types. The primary headache types include migraine.

5. Headaches that begin later in life over age 40 or so. Most people who are going to develop migraine or other primary headache types will do so before that age, although there are exceptions to this general rule.

6. A headache disorder that is rapidly getting worse over weeks or a few months.

7. Headaches that often awaken the patient at night, especially if there is associated vomiting. It is true, however, that some people with migraine experience headaches that wake them from sleep, and which may have nausea and vomiting.

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