OUCH(UK) Organisation for the Understanding of Cluster Headache

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Primary versus Secondary headache?

Primary headaches are defined as those where the headache is the condition itself, as opposed to ‘secondary’ headaches, where headache is caused by external factors, such as accidents, bleeds, infection or a brain tumour. This guideline has not been designed to assess secondary headaches and it is therefore important you see a specialist immediately if:

  1. Your headache had a sudden onset – particularly if it was abrupt and explosive in nature
  2. Your headache is or has been worsening over time
  3. You have been increasing the number of painkillers you are taking and they are becoming ineffective over time
  4. The pain intensity of your headache worsens when getting up or lying down
  5. Your headache includes visual impairment, or impairment to speech or other sensations, lasting longer than an hour
  6. You feel unwell, have a high temperature, or have other pain or discomfort symptoms e.g. neck stiffness
  7. You have recently experienced head injury, whiplash or another similar accident

Many people can also suffer from more than one primary headache type. Accordingly, please answer each question for one particular headache type only, the one that you feel is currently most bothersome or the most severe.

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