Headache in adults : investigations guide

Headache is one of the most common complaints encountered in primary care, affecting a significant proportion of the population at some point in their lives. The differential diagnosis of headache is broad, ranging from benign primary headaches, such as tension-type headaches and migraines, to serious secondary causes including intracranial pathology and systemic illness. A thorough assessment is crucial for identifying the underlying cause and guiding appropriate management. This involves a detailed history and physical examination, complemented by targeted investigations.

The table below outlines essential investigations that can help primary care clinicians evaluate and manage patients presenting with headaches.

Investigations for Headaches in Primary Care

Investigation	Reason	Possible Findings
Complete Blood Count (CBC) aka FBC	To identify signs of infection, inflammation, or hematologic conditions.	Elevated white cell count indicating infection, anemia in chronic disease
Erythrocyte Sedimentation Rate (ESR)	To detect non-specific inflammation. Elevated ESR can be seen in inflammatory, infectious, or neoplastic conditions.	Elevated ESR indicating inflammation or giant cell arteritis
C-Reactive Protein (CRP)	To assess for acute inflammation or infection.	Elevated CRP indicating acute inflammation or infection
Electrolytes (BMP/CMP)	To check for electrolyte imbalances that could contribute to headache.	Abnormal sodium, potassium, or calcium levels
Thyroid Function Tests (TFTs)	To...

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