Which Department

Which department should I see for a severe, persistent headache?

2026-09-17 · Neutral information that names no hospital, doctor or region. No rankings, recommendations or reviews.

Short answer

Neurology(신경과) is generally the first specialist department to evaluate severe or persistent headaches, as it focuses on disorders of the brain and nervous system. If imaging or surgical assessment is needed, a referral to Neurosurgery(신경외과) may follow. For a first visit, starting at a local clinic (의원) with an internal medicine or neurology physician is a common approach in Korea.

Which department

  1. 1Neurology(신경과)
    Neurologists specialize in conditions affecting the brain and nervous system, making them the primary specialists for evaluating recurring or severe headaches, including migraines and tension-type headaches. They assess patterns, triggers, and associated neurological symptoms to guide further evaluation. — First / second line: In Korea, patients often start at a neurology clinic (신경과 의원) for a first visit; if advanced imaging or further workup is needed, the clinic physician will generally issue a referral to a larger hospital.
  2. 2Neurosurgery(신경외과)
    Neurosurgeons manage conditions that may require surgical or procedural intervention, such as those involving structural abnormalities of the brain or spine that can cause headaches. They are typically involved after initial evaluation suggests a structural cause. — First / second line: A direct visit to a neurosurgery outpatient department is more common at a secondary or tertiary hospital (병원·종합병원), usually following a referral from a primary care or neurology physician.
  3. 3Internal Medicine(내과)
    General internal medicine physicians at local clinics are often the first point of contact in the Korean healthcare system and can perform an initial assessment, rule out systemic causes such as hypertension or infection, and provide a referral if a specialist is needed. — First / second line: Visiting an internal medicine clinic (내과 의원) first is practical when access to a neurology clinic is limited or when the headache may be related to a general medical condition.
  4. 4Ophthalmology(안과)
    Some persistent headaches are associated with eye conditions such as increased intraocular pressure or refractive errors; an ophthalmologist may be consulted when headache is accompanied by visual disturbances or eye discomfort. — First / second line: This is generally a secondary consideration — a primary care or neurology physician will typically suggest an ophthalmology consultation if eye-related causes are suspected based on your symptoms.

Go to the ER / call 119 if

If any of the following applies, do not choose a department — go to an emergency room or call 119 (Korea's emergency number).

  • A sudden, extremely severe headache that you would describe as the worst of your life, coming on within seconds.
  • Headache accompanied by fever, stiff neck, or sensitivity to light, which may suggest a serious infectious condition.
  • Headache with sudden weakness, numbness, slurred speech, or vision loss on one side of the body.
  • Headache following a head injury, even if the impact seemed minor at the time.
  • Headache with confusion, loss of consciousness, or seizure activity.

Before your visit

  • Note when the headache first started and whether it has been constant or comes and goes in episodes.
  • Record the location of the pain (front, back, one side, or all over) and describe the quality (throbbing, pressing, stabbing, etc.).
  • List any accompanying symptoms such as nausea, vomiting, visual changes, dizziness, or neck stiffness.
  • Bring a list of all medications and supplements you are currently taking, including any you use for the headache itself.
  • If you have had any previous imaging or blood test results related to this headache, bring those records or reports.
  • Note any factors that seem to trigger or worsen the headache, such as stress, sleep changes, bright lights, or physical activity.

General principles

Headaches are broadly categorized as primary (where the headache itself is the condition, such as migraine or tension-type) or secondary (where the headache is a symptom of another underlying condition). Because distinguishing between these types requires clinical evaluation, Neurology(신경과) is generally the first specialist involved, as neurologists are trained to assess headache patterns in the context of the nervous system as a whole.

In the Korean healthcare system, patients generally start at a primary care clinic (1차 의원) before moving to a larger hospital (2차·3차 병원) for specialist evaluation or imaging. A referral document (요양급여의뢰서) is legally required for normal insurance coverage only when visiting a tertiary hospital (상급종합병원); secondary hospitals (병원·종합병원) can be visited directly under standard health insurance (건강보험) coverage without one.

When a physician evaluates a severe or persistent headache, the general approach involves a detailed history, a neurological examination, and — when clinically indicated — imaging studies. The type and sequence of any investigation is determined by the examining doctor based on your specific presentation, not by the patient in advance.

If a structural cause is found or suspected on imaging, the care pathway may shift toward Neurosurgery(신경외과) for further assessment. For conditions identified as primary headache disorders, ongoing management typically remains within Neurology(신경과). The appropriate pathway will be guided by the physician who first evaluates you.

FAQ

Should I go to a local clinic or directly to a hospital for a severe headache?

In general, starting at a local neurology or internal medicine clinic (의원) is the standard first step in Korea for non-emergency cases. If the clinic physician determines that advanced imaging or specialist hospital care is needed, they may issue a referral. Going directly to a tertiary hospital (상급종합병원) without a referral will result in higher out-of-pocket costs under the national health insurance system, though secondary hospitals (병원·종합병원) can be visited directly without a referral and without any insurance penalty.

What is the difference between Neurology(신경과) and Neurosurgery(신경외과) for headaches?

Neurology focuses on diagnosing and medically managing conditions of the nervous system, and most headache cases are initially handled here. Neurosurgery becomes involved when evaluation suggests a structural problem that may require a surgical or procedural approach. A neurologist will generally guide you toward neurosurgery if that level of care is needed.

What kinds of examinations are generally done for persistent headaches?

The types of investigations used depend entirely on the clinical picture the doctor observes, so no specific test can be anticipated in advance. Generally speaking, physicians may consider blood tests, neurological function assessments, or imaging of the brain and surrounding structures as part of a thorough evaluation. The decision on what to examine, if anything, rests with the attending physician after a consultation.

Are there differences in how headaches are evaluated in children or older adults?

In children, headaches may be assessed with pediatric considerations in mind, and Pediatrics(소아청소년과) is often the first department involved before any specialist referral. In older adults, physicians may place greater emphasis on ruling out secondary causes such as vascular or structural conditions, which can influence which specialist is consulted first. In both cases, it is best to consult a physician who can tailor the evaluation to the individual's age and overall health status.

Related questions

Find a clinic (external directories)

External directories for finding a clinic by region once you know the department (public data, no rankings or recommendations).

This page is general medical information and does not replace diagnosis, treatment or choosing a clinic. Consult a doctor for any symptom. In an emergency, go to the ER or call 119 immediately.