Diagnostic Workup for Persistent Headache
Most headaches are tension-type or migraine and resolve without imaging. But certain patterns — sudden onset, new pattern in older adults, neurological symptoms — warrant a structured diagnostic workup.
Red flags that warrant imaging
Thunderclap onset (peak intensity within seconds), new headache in adults over 50, focal neurological signs (weakness, vision loss, speech difficulty), worsening pattern over weeks, headache with fever and neck stiffness, headache that wakes you from sleep.
First-line imaging: MRI vs CT
For most chronic headaches, MRI Brain with contrast is preferred over CT — better visualisation of brain parenchyma, posterior fossa, and pituitary. CT is faster (and so first-line in emergency settings for suspected bleed or stroke).
Recommended blood-test panel
CBC, ESR, CRP (rule out giant cell arteritis in adults >50), thyroid function (hypothyroidism can mimic chronic headache), vitamin B12 and D, fasting glucose, and blood pressure documentation across 3 days.
Frequently asked questions
Do I need a doctor’s referral for an MRI Brain at Saral?
Most patients walk in or self-refer; you’ll just need to describe symptoms. A neurologist consultation is recommended before booking if you want guidance on whether contrast is needed.
