Clinical Pearls and Red Flags

Abstract A good history is crucial. Listen to the patient uninterrupted first. Assess whether the headache is new and/or different. Look for the presence of “red flags.” Red flags can be remembered with the SNNOOP10 and SAIL mnemonics. If any, obtain work-up such as brain MRI rapidly. Most of headache diagnoses are made based on history. Patients recording headache days, symptoms, and medication use on a calendar is very helpful longitudinal data for both diagnostic purposes and monitoring. Make sure you address the patients’ expectations of their visit. Screen for aura and ask about exogenous estrogen use. Evaluate for and address comorbidities and risk factors for migraine chronification.