In this episode of OSCE Talk, Matthew and Peter break down how to take a structured headache history — one of the most common and important presentations in OSCEs and clinical practice.

We explore the different headache types, how to use the SOCRATES framework effectively, and the key associated symptoms you must always ask about.
You’ll also learn how to spot migraine aura, identify dangerous red flags, and recognise signs of raised intracranial pressure.

Key Points

• Most headaches are benign, but red flags must be recognised early.

• Use the SOCRATES structure for clear, systematic history taking.

• Ask about associated symptoms using a head-to-toe approach.

• Migraine aura can mimic stroke → take a clear timeline.

• Past medical and drug history are essential in diagnosis.

• Red flags include fever, weight loss, neurological deficits, immunosuppression, and sudden onset.

• Chronic headaches can relate to raised intracranial pressure.

• Weight and lifestyle factors influence headache patterns.

• Family history may help differentiate migraine types.

• Always consider the impact on daily functioning.