In order to receive proper treatment, a correct diagnosis of your headaches or migraines must be made. To properly diagnose the cause(s) of the headaches, your doctor will first take a headache history.

Headache History

The most important part of your doctor's evaluation of your headaches is what's called the headache history. It is important to describe your headache symptoms and characteristics as completely as possible. Your headaches can be better diagnosed if you tell your doctor:

How old you were when the headaches started
How long you have been experiencing them
If you experience a single type of headache or multiple types of headaches
How often the headaches occur
What causes the headaches, if known (for example, do certain situations, foods, or medications trigger the headaches?)
Who else in your family has headaches
What symptoms, if any, occur between headaches
If your school or work performance has been affected by the headaches

It is also important to tell your doctor how you feel when you get a headache and what happens when you get a headache, such as:

Where the pain is located
What it feels like
How severe the headache pain is, using a scale from 1 (mild) to 10 (severe)
How long the headache lasts
If the headaches appear suddenly without warning or with accompanying symptoms
What time of day the headache usually occurs
If there is an aura (changes in vision, blind spots, or bright lights) before the headache
What other symptoms or warning signs occur with a headache (such as weakness, nausea, sensitivity to light or noise, appetite changes, changes in attitude or behavior)
How frequently you get headaches

You should also tell your doctor if you've been treated in the past for headaches and what medications (both prescribed and over-the-counter) you have taken in the past and what medications are currently being taken. Don't hesitate to list them, bring the bottles, or ask your pharmacist for a printout.

Studies performed by other doctors who may have evaluated your headaches in the past, including X-rays and other imaging tests are also very important -- you should bring these to your appointment as well. This may save time and repetition of tests.

Physical and Neurological Exams to Diagnose Headaches

After completing the headache history portion of the evaluation, the doctor will perform a complete physical and neurological examination. The doctor will look for signs and symptoms of an illness that may be causing the headaches, such as:

Fever or abnormalities in breathing, pulse, or blood pressure
Infection
Nausea, vomiting
Changes in personality, inappropriate behavior
Mental confusion
Seizures
Loss of consciousness
Excessive fatigue, wanting to sleep all of the time
High blood pressure
Muscle weakness, numbness, or tingling
Speech difficulties
Balance problems, falling
Dizziness
Vision changes (blurry vision, double vision, blind spots)

Neurological tests focus on ruling out diseases of the brain or nerves that may also cause headaches and migraines, such as epilepsy or multiple sclerosis. Some of the tests may also look for a physical or structural abnormality in the brain that may cause your headache, such as:

Tumor
Abscess (an infection of the brain)
Hemorrhage (bleeding within the brain)
Bacterial or viral meningitis (an infection or inflammation of the membrane that covers the brain and spinal cord)
Pseudotumor cerebri (increased intracranial pressure)
Hydrocephalus (abnormal build-up of fluid in the brain)
Infection of the brain such as meningitis or Lyme disease
Encephalitis (inflammation and swelling of the brain)
Blood clots
Head trauma
Sinus blockage or disease
Blood vessel abnormalities
Injuries
Aneurysm (an outpouching of the wall of a blood vessel that can leak or rupture)