Other diagnostic tests

If the results of the physical exam show signs of a condition that may be causing the headaches, additional laboratory tests may be needed. These tests are listed below. Keep in mind that laboratory tests are not helpful in diagnosing migraine, cluster, or tension-type headaches.

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Blood chemistry tests and urinalysis. These are used to test for other medical conditions--including diabetes, thyroid problems and infections--that can cause headaches.

Computed tomography (CT scan). X-rays and computers are used to produce images of a cross-section of the body. A CT scan of the head might be recommended if you are getting daily or almost daily headaches to help rule out other causes. (Even in this age of magnetic resonance imaging, or MRI, the CT scan remains the procedure of choice to investigate brains for masses and bleeding.)

Magnetic resonance imaging (MRI). This test produces very clear images of the brain without the use of X-rays. MRI uses a large magnet, radio waves, and a computer to produce these images. An MRI provides information about the structure and biochemistry of the brain. An MRI might be recommended if you are getting daily or almost daily headaches. It might also be recommended if a CT scan does not show definitive results. In addition, an MRI scan is used to evaluate certain parts of the brain that are not as easily viewed with CT scans, such as the spine at the level of the neck and the back portion of the brain.

Sinus X-ray. CT scan and MRI provide more details; however, your doctor might use this test if your symptoms seem to indicate sinus problems.

Ophthalmology evaluation. An eye pressure test performed by an ophthalmologist will rule out glaucoma or pressure on the optic nerve as causes of headaches.

Lumbar puncture or spinal tap. A lumbar puncture or spinal tap is the removal of spinal fluid from the spinal canal. This diagnostic procedure is only done to rule out conditions that might be affecting the brain and spinal cord. This test can cause a headache for a few hours afterward.

An electroencephalogram (EEG) is generally unnecessary but would be used if a person has lost consciousness during a headache.

More detail is provided about:

• CT scans
• MRI
• EEG