▁a ▁lum bar ▁pun ct ure ▁to ▁look ▁for ▁men ing itis ▁should ▁be ▁considered . ▁If ▁there ▁is ▁j aw ▁cla ud ic ation ▁and ▁scal p ▁tend ern ess ▁in ▁an ▁older ▁person , ▁a ▁temporal ▁ar tery ▁bi ops y ▁to ▁look ▁for ▁temporal ▁ar ter itis ▁should ▁be ▁performed ▁and ▁immediate ▁treatment ▁should ▁be ▁started . ▁ ▁Ne uro im aging ▁ ▁Old ▁head aches ▁ ▁The ▁US ▁Head ache ▁Cons ort ium ▁has ▁gu idel ines ▁for ▁ne uro im aging ▁of ▁non - ac ute ▁head aches . ▁Most ▁old , ▁chron ic ▁head aches ▁do ▁not ▁require ▁ne uro im aging . ▁If ▁a ▁person ▁has ▁the ▁characteristic ▁sympt oms ▁of ▁a ▁mig raine , ▁ne uro im aging ▁is ▁not ▁needed ▁as ▁it ▁is ▁very ▁unlikely ▁the ▁person ▁has ▁an ▁int rac ran ial ▁ab normal ity . ▁If ▁the ▁person ▁has ▁ne uro log ical ▁find ings , ▁such ▁as ▁weak ness , ▁on ▁exam , ▁ne uro im aging ▁may ▁be ▁considered . ▁ ▁New ▁head aches ▁ ▁All ▁people ▁who ▁present ▁with ▁red ▁flags ▁indicating ▁a ▁dangerous ▁secondary ▁head ache ▁should ▁receive ▁ne uro im aging . ▁The ▁best ▁form ▁of ▁ne uro im aging ▁for ▁these ▁head aches ▁is ▁controvers ial . ▁Non - contr ast ▁computer ized ▁tom ography ▁( CT ) ▁scan ▁is ▁usually ▁the ▁first ▁step ▁in ▁head ▁imag ing ▁as ▁it ▁is ▁readily ▁available ▁in ▁Emer gency ▁Depart ments ▁and ▁hosp it als ▁and ▁is ▁che aper