Headache Diagnostic Tool
HDT
help
Please fill out the form below:
1.
*
Headache duration
second(s)
minute(s)
hour(s)
day(s)
2.
*
In the hour
before
it started, did you notice eyesight interference
such as flashing lights, zigzag lines, blind spots or temporary hand, leg
or face numbness?
No
Yes
3.
*
Was the headache on one side of the head or both?
One
Both
4.
*
What was the headache quality?
Pulsating
Pressing
Throbbing
5.
*
Did physical activity (such as walking upstairs) make the headache worse?
No
Yes
6.
*
How bad was your headache overall?
Not bad
Quite bad
Very bad
7.
*
Were you nauseated? (did you feel you were going to be sick)?
No
Yes
8.
*
Did you throw up?
No
Yes
9.
*
Were you bothered by the light?
No
Yes
10.
*
Were you bothered by the noise?
No
Yes
11.
*
Were you bothered by the smell?
No
Yes
12.
*
During headache, did you have one of the following: eye redness,
tearing eye, pupil constriction, lower eyelid, runny nose or nasal
congestion, sweating half of the face?
No
Yes
* These fields are mandatory