ABSTRACT
One of the most common complaints in a neurology/neurosurgery patient setting is complaint of a headache. A tension-type headache usually presents as mild to moderate, is usually bilateral, and is commonly described as "pressure-like", "band-like", or "heavy weight on my head". Another benign headache is a cluster headache. These are unilateral, usually severe orbital or temporal attacks associated with autonomic symptoms such as lacrimation, rhinorrhea, diaphoresis, ptosis, or miosis on the same side as the headache. More critical types of headaches include a subarachnoid hemorrhage, subdural hematoma, vascular malformations, brain tumors, cerebral spinal fluid leak, or central nervous system infection. Serious causes need to be recognized quickly. A subarachnoid hemorrhage or subdural hematoma typically present with a sudden onset of a severe headache usually described as the "worst headache of my life". Brain tumors or vascular abnormalities do not always present acutely. Both benign and malignant tumors can manifest similarly and need to be addressed urgently.
