Migraine is diagnosed on the basis of history and physical examination.
Optional medical device diagnostics – depending on the results of the history, physical examination, laboratory diagnostics, and obligatory medical device diagnostics – for differential diagnosis in cases of atypical headache or other accompanying symptoms.
- Magnetic resonance imaging of the skull (cranial MRI, cranial MRI or cMRI) – for suspected parenchymal changes as well as abnormalities; furthermore for:
- First occurrence of an “aura” after the age of 40.
- Atypical headache
- Recently existing changes in the pattern of pain (eg, attack cluster).
- Accompanying fever without flu-like infection
- Severe one-sidedness
- Neurological abnormalities
- Epileptic seizures
- Persistent (“lasting over a long period of time”) deficits.
- Personality changes
- Computed tomography of the skull (cranial CT, cranial CT or cCT) – if hemorrhage or bony lesions (injuries) are suspected.
- Angio-CT or angio-MRI – for suspected sinus vein thrombosis (SVT; occlusion of a cerebral sinus (large venous blood vessels of the brain arising from duraduplications) by a thrombus (blood clot)).
- Digital subtraction angiography (DSA; procedure for isolated imaging of vessels) – in cases of suspected aneurysms (arterial dilation) or vasculitides (diseases in which autoimmunological processes lead to inflammation of arteries, arterioles, and capillaries)
- Encephalogram (EEG; recording of the electrical activity of the brain) – if seizures are suspected.
- X-rays of the cervical spine – if vertebragene (spinal) cause of the headache is suspected.
- X-rays of the paranasal sinuses or computed tomography (CT; sectional imaging method (X-rays from different directions with computer-based evaluation)) of the paranasal sinuses – if sinusitis (sinusitis) is suspected.
- Neurophysiological examinations – if neuritis (inflammation of the nerves) is suspected.
- Doppler/duplex sonography (ultrasound examination: combination of a sonographic cross-sectional image (B-scan) and the Doppler sonography method; imaging method in medicine that can dynamically represent fluid flows (especially blood flow)) – if dissection (splitting of vessel wall layers) is suspected.
- Polysomnography (sleep laboratory; measurement of various body functions during sleep, which provide information about the quality of sleep) – on suspicion of sleep apnea syndrome (symptom caused by respiratory arrest (apnea) during sleep).
