Answer
Answer 21-1. There are several worrisome signs and symptoms of headache:
Sudden onset worst headache of life - subarachnoid hemorrhage
Sudden onset headache with focal neurologic deficit - intracerebral hemorrhge
New or different headache in older patient - giant cell (temporal) arteritis
Headache that awakens from sound sleep - increased intracranial pressure
Escalating headache that is always in the same location - focal lesion such as tumor, abscess or hemorrhage
Headache associated with a focal neurological deficit - focal lesion
Headache with recent head trauma, systemic disease, fever, malignant hpertension
Positional or exertional headache - obstruction of CSF flow