ABSTRACT
Headache therefore arises from the various pain-sensitive structures of the head and neck, namely the meninges, blood vessels, muscles, sinuses, eyes, teeth and gums. Headache, like other forms of pain, may also be neuropathic in origin. Raised intracranial pressure most probably causes headache as a result of traction on the meninges and intracranial blood vessels. The causes of headache may be conveniently classified into the following five categories: vascular; infectious; inflammatory; miscellaneous; and extracranial disease. Headache is an extremely common symptom, and although most cases are managed entirely in primary care, a minority represent serious pathology that demands urgent investigation and treatment. Signs of meningeal irritation include neck stiffness, Kernig's sign and Brudzinski's sign. Fundoscopy may reveal papilloedema, which is a sign of raised intracranial pressure. Subhyaloid haemorrhage may accompany subarachnoid haemorrhage.
