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CC BY 4.0 · Arq Neuropsiquiatr 2025; 83(12): s00451813240
DOI: 10.1055/s-0045-1813240
Review Article

“NÃO É PRIMÁRIA”: a Portuguese version of the SNNOOP10 mnemonic

Authors

  • Davi Coutinho Marcelino Guerra Leone 

    1   Universidade Federal da Paraíba, Centro de Ciências Médicas, Departamento de Medicina Interna, Serviço de Neurologia, João Pessoa PB, Brazil.

  • Antonio Fernando Soares Menezes Segundo 

    2   Afya Faculdade de Ciências Médicas da Paraíba, João Pessoa PB, Brazil.

  • Alex T. Meira 

    1   Universidade Federal da Paraíba, Centro de Ciências Médicas, Departamento de Medicina Interna, Serviço de Neurologia, João Pessoa PB, Brazil.
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Abstract

Background

Secondary headaches arise from underlying medical conditions and are associated with significant morbidity and mortality. Their diagnosis relies primarily on a comprehensive clinical history and a thorough physical examination, both aimed at identifying key warning signs. The SNNOOP10 mnemonic is a widely-recognized tool used to screen for potential secondary causes of headache. It consists of a structured checklist of 15 red flags, with validated sensitivity, specificity, and predictive values. However, the original English version may present challenges for healthcare providers who are non-native English speakers.

Objective

To introduce a culturally-adapted version of the SNNOOP10 mnemonic in Portuguese: “NÃO É PRIMÁRIA” (“IT IS NOT PRIMARY”).

Methods

The authors reorganized the SNNOOP10 red flags into “NÃO É PRIMÁRIA” by semantically grouping related items, assigning each letter to a corresponding clinical element and matching the original red flags into each letter of the new acronym. A comparative table and image were developed to ensure clarity.

Results

The new mnemonic covers all reorganized items of the SNNOOP10 adapted for Portuguese speakers.

Conclusion

“NÃO É PRIMÁRIA” is a practical mnemonic that adapts THE SNNOOP10 for Portuguese-speaking settings, based on clinical experience. It requires formal validation, and future studies should assess its diagnostic accuracy and applicability.

Keywords

Headache - Neurologic Examination - Secondary Headache Disorders - Neuroimaging

Authors' Contributions

Conceptualization: AFMS; Project administration: DCMGL, ATM; Supervision: ATM; Writing – original draft: DCMGL; Writing – review & editing: AFMS, ATM.


Data Availability Statement

Data will be available upon request to the corresponding author.


Editor-in-Chief: Hélio A. G. Teive https://orcid.org/0000-0003-2305-1073.


Associate Editor: Pedro André Kowacs https://orcid.org/0000-0001-7770-7475.




Publication History

Received: 29 May 2025

Accepted after revision: 18 September 2025

Article published online:
08 December 2025

© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit (https://creativecommons.org/licenses/by/4.0/)

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Bibliographical Record
Davi Coutinho Marcelino Guerra Leone, Antonio Fernando Soares Menezes Segundo, Alex T. Meira. “NÃO É PRIMÁRIA”: a Portuguese version of the SNNOOP10 mnemonic. Arq Neuropsiquiatr 2025; 83: s00451813240.
DOI: 10.1055/s-0045-1813240