Tension Headache Workup

Updated: Nov 15, 2022
  • Author: Michelle Blanda, MD; Chief Editor: Jeter (Jay) Pritchard Taylor, III, MD  more...
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Approach Considerations

Laboratory work should be unremarkable in cases of tension-type headache. Specific tests should be obtained if the history or physical examination suggests another diagnostic possibility.

Head CT scan or MRI is necessary only when the headache pattern has changed recently, the headache cannot be clearly defined by the clinician as a common primary headache disorder (that is not a cluster, migraine, or tension-type of headache), or neurologic examination reveals abnormal findings. [11] Such history or physical examination evidence would suggest an alternate cause of headache. Caution should be used in patients with aura in headache that is sensory or motor, or if the aura has changed in character and is not described as typical of their migraine aura. These patients may warrant neuroimaging.