What is Headaches & Migraine?
Headaches come in many types — tension-type, migraine, cluster, medication-overuse, and the rare secondary headaches pointing to a tumor or aneurysm. Diagnosis is clinical; imaging is only needed for specific red flags. Modern therapy (CGRP antibodies, Botox for chronic migraine, triptans for acute) has transformed outcomes.
When a second opinion really helps
- You take painkillers >10 days a month — you may have medication-overuse headache.
- Preventive medication was never offered despite 4+ bad migraine days/month.
- Chronic migraine >15 days/month — you may benefit from Botox or CGRP antibodies.
- MRI was done but never reviewed by a headache specialist.
Red flags — call 108 / 102 immediately
- Thunderclap headache ('worst ever, peaks in seconds')
- Headache + fever + neck stiffness
- New headache after age 50
- Headache after head trauma that worsens
Frequently asked questions
Not usually. MRI is needed if red flags are present, pattern changes, or focal neuro signs appear. For typical migraine, clinical diagnosis is enough.