UMEM Educational Pearls

Title: SNOOP for Headache Red Flags

Category: Neurology

Keywords: secondary headache, features, risk factors, red flags (PubMed Search)

Posted: 7/10/2019 by WanTsu Wendy Chang, MD
Click here to contact WanTsu Wendy Chang, MD

Symptoms/signs that suggest serious underlying conditions causing headaches are summarized by the mnemonic SNOOP:
- S - Systemic symptoms/signs/disease
  - e.g. fever, weight loss, HIV, malignancy, pregnancy
- N - Neurologic symptoms/signs
  - e.g. altered mental status, diplopia, pulsatile tinnitus, loss of consciousness
- O - Onset sudden, abrupt, thunderclap
  - i.e. pain reaches maximal intensity instantly after onset
- O - Older age of onset, especially > 50 years
- P - Pattern change
  - e.g. change in frequency, severity, clinical features, precipitated by Valsalva, aggravated by postural change
Consider structural pathologies, vascular disorders, infectious and inflammatory conditions in the evaluation of secondary headache syndromes.

Chou DE. Secondary headache syndromes. Continuum (Minneap Minn) 2018;24(4, Headache):1179-91.
Doric DW. Pearls: headache. Semin Neurol 2010;30(1):74-81.

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