Pain location alone does not establish the diagnosis.
Head, face and headache conditions
Headache Disorders
Headache is a symptom category, not one diagnosis. Migraine and other primary headache disorders, cranial neuralgias, cervical referral, medication effects, and secondary causes require different evaluation and treatment pathways.
Quick orientation
What to know first
Primary headache, cranial neuralgia, cervical referral, eye, sinus, dental, vascular, and other causes can overlap.
Red flags and a changing neurologic pattern can change the timing and destination of care.
What we may consider next
How we may treat this
These options depend on the diagnosis, exam findings, prior care, goals, and individual risk review. A listed pathway does not establish candidacy or guarantee a later procedure.
Options that may be considered
These are options, not required steps. Selection depends on the diagnosis and individual review.
Treatment option
Sphenopalatine Ganglion Block
May be considered for selected diagnosed headache or craniofacial pain presentations; it is not mapped to every headache, evidence varies by subtype, and clinical review is required.
Choose the guide that matches your question
Explore the specific guides.
Use these links to learn about related symptoms, conditions, and treatments. An individual evaluation is still needed to determine a diagnosis or whether a treatment may be appropriate.
Clinical guide
Cervicogenic Headache
Cervicogenic headache symptoms, cervical pain generators, evaluation, and relevant treatment pathways.
Open this guideClinical guide
Occipital Neuralgia
Occipital neuralgia symptoms, diagnosis, differential considerations, and relevant treatment pathways.
Open this guideClinical guide
Auriculotemporal Neuralgia
Auriculotemporal-distribution facial or temporal pain, diagnostic differentiation, and appropriately selected treatment pathways.
Open this guideClinical guide
Infraorbital Neuralgia
Infraorbital-distribution facial pain, diagnostic differentiation, and appropriately selected treatment pathways.
Open this guideClinical guide
Supraorbital Neuralgia
Supraorbital-distribution forehead pain, diagnostic differentiation, and appropriately selected treatment pathways.
Open this guideSymptoms are clues, not a diagnosis
What the pattern can feel like
Symptoms help define a syndrome, but they do not confirm which structure is responsible. Distribution, timing, aggravating factors, neurologic findings, function, and important alternatives all shape the evaluation.
Timing, attack duration, quality, triggers, sensory changes, nausea, light sensitivity, autonomic features, and tenderness help define the pattern.
A named superficial nerve territory can be relevant, but neighboring branches and primary headache disorders may overlap.
Function, sleep, medication use, trauma, infection, systemic disease, and progression shape the evaluation.
Relevant anatomy
Anatomy and pain mechanisms
Pain can arise through multiple cranial, cervical, vascular, meningeal, muscular, and sensory pathways. The International Classification of Headache Disorders organizes primary and secondary diagnoses, but classification still depends on the history, examination, and appropriate exclusion of dangerous causes.
History and examination first
How the diagnosis is evaluated
Evaluation begins with classification of the headache or neuralgia pattern, a focused neurologic and craniofacial examination, review of red flags, and selective testing or referral. A tender point or temporary block response can add information but does not independently prove the diagnosis.
Keep the differential open
What else can look similar
Keep common and serious alternatives open until the evidence supports a narrower conclusion.
Primary migraine, tension-type, trigeminal autonomic, or other headache disorder
Cervicogenic headache, occipital neuralgia, or another cranial neuralgia
Eye, sinus, dental, temporomandibular, vascular, infectious, inflammatory, traumatic, or medication-related causes
Core care
Conservative and coordinated care
Procedure discussions belong inside a broader plan that protects neurologic function and daily activity.
Diagnosis-specific education and a headache or symptom diary when useful
Medication and overuse review with the appropriate clinician
Physical or behavioral strategies matched to the diagnosis and functional goals
Reassessment when pattern, neurologic findings, frequency, or treatment response changes
Evidence at a glance
Evidence at a glance
Evidence strength, comparator, follow-up, and selection affect interpretation.
ICHD-3 separates primary headache disorders, secondary headaches, and painful cranial neuropathies using diagnosis-specific criteria.
Migraine treatment evidence does not establish a procedure pathway for every headache.
Sphenopalatine and peripheral nerve interventions have heterogeneous evidence across headache subtypes and techniques.
Decision quality matters
Evidence, limits, and who it may fit
A listed option does not establish candidacy. Diagnosis, anatomy, prior care, risk, alternatives, goals, and evidence must align.
Referral and urgent signs
When urgent or different evaluation matters
These findings can change the timing or destination of care.
A sudden severe headache that reaches maximum intensity rapidly
New weakness, confusion, fainting, seizure, fever with neck stiffness, or new vision loss
Headache after major trauma, during pregnancy or postpartum, with cancer or immune suppression, or with a rapidly changing pattern
The visit
What to expect at an evaluation
The visit should narrow the diagnosis, identify safety and referral needs, review imaging and prior care in context, and choose the next useful decision. The clinician should explain uncertainty and what a treatment is expected to add before it is performed.
Define the exact pain pattern, timing, associated symptoms, triggers, and functional effect
Perform a neurologic, head and neck, cranial nerve, musculoskeletal, and sensory examination as appropriate
Use imaging, laboratory testing, ophthalmic, dental, ENT, or neurologic referral selectively
Choose education, medical management, rehabilitation, a target-specific procedure discussion, or referral without assuming a fixed sequence
Common questions
Headache Disorders FAQ
These answers are educational and cannot determine an individual diagnosis or treatment plan.
Are all recurrent headaches migraine?
No. Migraine is common, but other primary headache disorders, neuralgias, cervical referral, medication effects, and secondary causes can overlap.
Does a normal scan rule out every serious cause?
No. Imaging is selected and interpreted in the context of the pattern, examination, timing, and specific clinical concern.
When is headache urgent?
A sudden severe onset, new neurologic deficit, fever with neck stiffness, new vision loss, seizure, major trauma, or a rapidly changing pattern needs prompt evaluation.
Diagnosis before procedure
Start with a careful evaluation
A focused evaluation can clarify the diagnosis, important alternatives, and the next step that fits the clinical picture.
