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Description of the Symptom

This chapter describes pathology that may lead to headaches. Local causes are defined as pathology occurring within the cranial vault, as well as the temporomandibular joint (Fig. 7-1). Remote causes are defined as occurring outside this region. Each symptom description in this chapter is followed by a brief summary of clinical presentation.


Local causes of headache include cranium, contents of the cranial vault, articular and periarticular structures of the temporomandibular joint, and nasal sinuses. (A) Anterior lateral view; (B) posterior lateral view.

Special Concerns

Headache with:

  • Awakening from sleep

  • History of head trauma inside of 2 weeks

  • Neurological symptoms, such as dizziness, paresthesias, or weakness

  • New onset after age 50

  • New onset of headache in patient with risk factors for cancer or HIV infection

  • Progressing intensity or frequency

  • Signs of illness, such as fever, nuchal rigidity, or rash

  • Signs of papilledema

  • Sudden onset of headache

  • Worsening with exertion or Valsalva maneuver

CHAPTER PREVIEW: Conditions That May Lead to Headache

Overview of Headache

The International Headache Society ...

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