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poorly managed in primary care but only 1 in 1000 have tumour
Mostly cluster, tension, migraine, secondary, other

Don't miss ... meningococcal, berry aneursym, tumour, temporal arteritis, carotid dissection, acute closed angle glaucoma, CO poisoning, SAH

Red flags >1% chance serious ...
abN neurology, papilloedema, new cluster, Hx cancer elsewhere (current)
Orange flags 0.1-1% serious ...
occurs with valsalva, change in frequency, new onset >50, wake from sleep, unresolved in 6-8/52

Note - cluster headache
unilat occurs daily at same time for few days then again few weeks later, associated antonomic Sx (sweating)

Key steps
5 questions 
how many pain killers being taken ? 
how many types of headache is there ? 
impact of headache (migraine - lay down, tension - keep going, cluster - bang head)
if migraine - FH, age when started (late teens), frequency, nausea, photophobia
what does pt think causes this ?
2 examinations
BP and fundoscopy (early - hyperaemia, moderate - blurred disc, patton lines, late - no disc)
1 delay tactic
keep diary, next time double appt, measure impact with MIDAS (looks at impact on life over 3/12)or HIT score