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Headache Red Flags – SNOOP Mnemonic — SCE Neurology MCQ

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HardHeadache & Facial PainHeadache Red Flags – SNOOP MnemonicSCE Neurology

A 50-year-old man presents with a severe headache with red flag features. His neurologist uses the 'SNOOP' mnemonic to screen for secondary causes. What does the 'S' in SNOOP stand for?

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Correct answer: A — Systemic symptoms (fever, weight loss) or systemic disease (cancer, HIV, immunosuppression)

The best answer is “Systemic symptoms (fever, weight loss) or systemic disease (cancer, HIV, immunosuppression)”. Primary headache diagnosis follows attack phenotype and absence of secondary red flags; acute and preventive treatment is selected by headache type, frequency, disability and contraindications. The alternatives “Stress, after excluding important mimics, after specialist assessment, when the phenotype supports it”, “Sleep disturbance, after specialist assessment, when the phenotype supports it”, “Side-locked headache, when the phenotype supports it, within the relevant UK pathway”, “Seizure, within the relevant UK pathway, after excluding important mimics” are clinically adjacent possibilities, but they do not match the defining chronology, localisation, physiology, investigation result or UK management sequence in this stem.

Reference: NICE CG150 headache recommendations: https://www.nice.org.uk/guidance/cg150/chapter/Recommendations