At the National Headache Institute in Miami, Florida we are committed to expert headache diagnosis, which enables us to provide the most effective treatment.

The medical professionals at our headache center take the time to carefully explore the condition of each headache patient so we can make sure we are properly diagnosing the root cause of their condition. There is no other medical facility center in South Florida or Miami that can compare with our migraine diagnosis experience.

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In the United States, primary and secondary headaches are among the top reasons for doctor’s office visits, while migraines are the leading type of headache among patients seeking emergency room or medical office care. A headache is a symptom that can have many different causes from tension and viruses to tumors or disease.

Nearly one in four American households have a member suffering from migraines. That is approximately 28 million people in this country alone. That translates to 18% of the female population and 6% of the male who suffers migraines. In 1988 the International Headache Society (IHS) categorized headaches into two basic types. Primary headache disorders include migraines, tension headaches, cluster headaches and headaches associated with exertion, colds and other benign conditions and activities. Secondary headaches are caused by evolving disorders like brain tumors, aneurysms, head trauma, and brain hemorrhaging or inflammation.



  1. Tension Headaches
  2. Migraines
  3. Cluster Headaches
  4. Cold Induced Headaches
  5. Headaches associated with sexual activity
  6. Cough and sneezing headaches
  7. Exertion headaches


  1. Brain Tumor or Abscess
  2. Brain Hemorrhage
  3. Brain Inflammation
  4. Intracranial Pressure
  5. Aneurysm
  6. Arteriovenous Malformation
  7. Head trauma, and hematoma
  8. Meningitis or encephalitis
  9. Cerebrovascular disease
  10. Neuralgias
  11. Sinusitis

It is important to differentiate the type of headache in question, whether primary or secondary. This is done with a thorough neurological examination and complete patient history. Answers to the following questions will guide the diagnosis.

  1. How long have you suffered from headaches?
  2. Is there anything that triggers your headaches?
  3. Do you experience an aura, flashing lights, numbness or other symptoms?
  4. Is there a history of headaches in your family?
  5. Current and past treatment
  6.  Location, severity, and description of pain

Additionally, these comfort features are reliable aides in migraine diagnosis.

  1. Family migraine history
  2. Changes in headache locations
  3. Menstrual association
  4. Auras or prodromes
  5. Reliable headache pattern
  6. Good overall health
  7. Sleep resolution
  8. Meets IHS criteria

Secondary headache disorders will often include signaling items in the patient history and examination results that will alert the physician to evaluate further. The following lists outline these features.



  1. Headache pattern change
  2. Onset after the age of fifty
  3. An apoplectic event
  4. First or worst headache experienced
  5. A subacute headache that worsens progressively
  6. Headaches brought on by sneezing, coughing, sex or exertion
  7. Headaches that resist treatment


  1. Numbness, loss of coordination or paralysis
  2. Drowsiness or weakness
  3. Memory loss or confusion
  4. Sensory loss
  5. Neurological changes
  6. Meningeal irritation


  1. Weight loss
  2. Stiff neck
  3. Chronic cough or nasal drainage
  4. Fever
  5. Tender temporal arteries

Most headaches can be diagnosed without the use of neuro-imaging which is often used to rule out secondary headache disorders. For our Miami patients with acute headaches where head trauma or bleeding is possible, a CT scan may be called for. Below are the guidelines for using MRI and CT scan to diagnose headaches.

  1. An abnormal neurological examination
  2. Onset after the age of fifty
  3. First or worst headache experienced
  4. Increased headache frequency and/or severity
  5. Headache pattern change
  6. Abrupt onset after sneezing, coughing, sex or exertion


A shortlist of famous people that have suffered from migraines include psychoanalyst Sigmund Freud, Roman emperor Julius Caesar, French emperor Napoleon Bonaparte, US soccer player Michelle Akers, and Los Angeles Laker Kareem Abdul Jabbar.