Headache

Headache — referral criteria for Neurology services.

Full SRC reference

Eligibility

At least one must be met for the patient to be eligible for referral.

Clinically suspected or confirmed headache with initial primary-care work-up completed

Red flags

Indicate urgent (Category 1) referral or emergency assessment.

Headache with — sudden onset or thunderclap headache

Headache with — severe headache with signs of systemic illness (fever, neck stiffness, vomiting, confusion, drowsiness, dehydration)

Headache with — severe disabling headache

Headache with — severe headache associated with recent head trauma

Headache suggesting temporal artheritis (focal neurological symptoms, altered vision, elevated erythrocyte sedimentation rate and C-reactive protein in patients older than 50 years of age)

Routine referral criteria

Determine Category 2 or 3 urgency.

Chronic headache with concerning clinical signs

Concerning features on neuroimaging (excluding age-appropriate deep white matter)

Severe frequent migraine impacting on daily activities (e.g. work, study, school or carer role) despite prophylactic treatment

Chronic or atypical headache unresponsive to medical management (e.g. cluster headache, trigeminal neuralgia, medication overuse headache)

Usually managed in primary care

Mild or tension headache
Untreated typical migraine
Isolated migraine in patients with an established diagnosis
Chronic migraine already being managed by a neurologist