As a person in need of a neurological consultation the following pointers are important in the history you give the neurologist…
Neurology Insights: February 2024
A headache is a common symptom that a neurologist is consulted for and the causes are vast. The focus on this segment is not to discuss the different causes of headaches but to zoom in on the red and orange flags that the headache might not be benign. Do et al, proposed the SNNOOP10 list to assist clinicians to identify red or orange flags to assist with prompt investigations and management. The following table highlights these points:
| Sign or symptom | Flag colour |
| Systemic symptoms including fever | Red or orange |
| Neoplasms in history | Red |
| Neurological deficit or dysfunction (e.g. weakness or blindness) including reduced level of consciousness | Red |
| Onset of headache is sudden or abrupt | Red |
| Older age (after 50 years) | Red |
| Pattern change or recent onset of headache | Red |
| Positional headache | Red |
| Precipitated by sneezing, coughing or exercise | Red |
| Papilledema (swelling inside the eye) | Red |
| Progressive headache and atypical presentation | Red |
| Pregnancy or Puerperium(6 weeks period after giving birth) | Red |
| Painful eye with autonomic features | Red |
| Post traumatic onset of headache | Red |
| Pathology of immune system like HIV | Red |
| Painkiller overuse or new drug at onset of headache | Red |
Reference
Do et al. Red and Orange flags for secondary headaches in clinical practice SNNOOP10 list. Neurology. 2019 Jan 15; 92(3): 136. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6340385 doi.org/10.1212%2FWNL.0000000000006697