In patients with nonacute headache and unexplained findings on neurologic examination, neuroimaging should be considered.

In patients with neurologic symptoms (headache that is worsened with use of Valsalva's maneuver, awakens the patient from sleep, is newly onset in an older person, or is progressively worsening), the evidence is insufficient to make specific recommendations. The conservative approach would be to consider neuroimaging in these patients.

In patients with a normal neurologic examination, neuroimaging is usually not warranted. However, if the headache has atypical features or does not meet the strict definition of migraine, a lower threshold may apply.