SNOOP10

 Q:  What is SNOOP10?

Answer:  SNOOP10 is a mnemonic which reminds a clinician of 'danger signs' that headache can be secondary to a serious underlying pathology other than simple migraine. There may be a stroke, infection, metabolic encephalopathy or a systemic disease. 

• Systemic symptoms like fever
• Neoplasm 
• Neurologic deficit (or mental status change)
• Onset (sudden) 
• Old age 
• Pattern change (a new type of headache)
• Position (headache change by position)
• Precipitating factors like sneeze, cough, or exercise
• Papilledema
• Progressive headache 
• Pregnancy (puerperium)
• Painful eye 
• Post-traumatic onset 
• Pathology of the immune system (e.g., HIV)
• Painkiller overuse (i.e., medication overuse headache or drug-induced headache)

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Reference:

Do TP, Remmers A, Schytz HW, et al. Red and orange flags for secondary headaches in clinical practice: SNNOOP10 list. Neurology 2019; 92:134.