The doctor will ask about your symptoms and medical history, and perform a physical exam. The cause of a headache can be difficult to determine. The doctor will ask about the frequency and pattern of your headaches. To help provide answers, keep a diary of:

    
  • When your headaches start and end
  • What you were doing at the time
  • What you did to try to relieve pain and how effective the treatment was
  • Family members with the same condition
  • Triggers that you are aware of
  • Where the pain is located and where it spreads to
  • Other symptoms associated with the pain
  • Tests to determine the cause of headaches include:

        
  • Neurological exam to assess:     
  • Muscle strength
  • Coordination
  • Reflexes
  • Sensation
  • Mental status
  • Cranial nerve function
  • Blood tests—Blood tests may be done to exclude other causes of your headache. These include blood glucose, a complete blood count looking for anemia or infection, as well as other studies to potentially look for evidence of inflammation.
  • Lumbar puncture—During this procedure, spinal fluid is collected to look for bleeding, infections, or cancer. The opening pressure may also be measured.
  • Imaging tests are used to evaluate internal structures for abnormalities. Some tests may use contrast material to make structures easier to see. These may include:

        
  • X-rays.
  • CT scan
  • MRI scan
  • Nasal endoscopy—A thin, lighted tube with a camera is inserted into the nasal cavity. If needed, tissue samples can be taken for examination under a miroscope.