Walsh & Hoyt: Headache Attributable to Cranial and Cervical Vascular Disorders

Headache may be associated with vascular disorders. In some of these conditions, such as ischemic or hemorrhagic stroke, the headache is overshadowed by focal neurologic deficits. In others, such as subarachnoid hemorrhage, headache may be the presenting symptom. Headache may be an initial warning symptom in a number of diseases, including carotid artery dissection, giant cell arteritis, and cerebral venous thrombosis. The clinician should therefore be aware of the association of headache with these potentially neurologically and visually devastating diseases. The sudden onset of a new headache should always raise suspicion of a vascular etiology, particularly when the headache is severe (""first and worst headache"").