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Secondary headaches are emphasized as deriving from underlying conditions and requiring early identification through clinical history and physical examination. The study describes reorganization of 15 SNNOOP10 items into the Portuguese acronym “NÃO É PRIMÁRIA” by semantic grouping and letter-to-element mapping, supported by a comparative table and an illustrative figure. Results indicate full coverage of reorganized items for Portuguese speakers, while validation remains required.",{"@graph":59,"@context":114},[60,77,97],{"@type":61,"itemListElement":62},"BreadcrumbList",[63,68,71,74],{"item":64,"name":65,"@type":66,"position":67},"https://docshare.wps.com","Home","ListItem",1,{"item":69,"name":9,"@type":66,"position":70},"https://docshare.wps.com/pt/document/",2,{"item":72,"name":43,"@type":66,"position":73},"https://docshare.wps.com/pt/document/saúde-e-cuidados/",3,{"item":75,"name":55,"@type":66,"position":76},"https://docshare.wps.com/pt/document/nao-e-primaria-a-portuguese-version-of-the-snnoop10-mnemonic/438587/",4,{"url":75,"name":55,"@type":78,"image":79,"author":84,"headline":55,"publisher":87,"fileFormat":90,"inLanguage":53,"description":57,"dateModified":91,"datePublished":91,"encodingFormat":90,"isAccessibleForFree":92,"interactionStatistic":93},"DigitalDocument",{"url":80,"@type":81,"width":82,"height":83},"https://docshare.wps.com/thumbnails/nao-e-primaria-a-portuguese-version-of-the-snnoop10-mnemonic/438587.png","ImageObject",300,407,{"name":85,"@type":86},"Patrick","Person",{"url":64,"name":88,"@type":89},"DocShare","Organization","application/pdf","2026-09-29",true,{"@type":94,"interactionType":95,"userInteractionCount":4},"InteractionCounter",{"@type":96},"ViewAction",{"@type":98,"mainEntity":99},"FAQPage",[100,106,110],{"name":101,"@type":102,"acceptedAnswer":103},"O que são as cefaleias secundárias e por que reconhecer “sinais de alerta” é importante?","Question",{"text":104,"@type":105},"As cefaleias secundárias decorrem de condições médicas subjacentes e se associam a morbidade e mortalidade significativas. O reconhecimento precoce baseia-se em história clínica e exame físico detalhados para identificar sinais de alerta indicativos de etiologia secundária.","Answer",{"name":107,"@type":102,"acceptedAnswer":108},"Qual é o objetivo do estudo “NÃO É PRIMÁRIA”?",{"text":109,"@type":105},"O objetivo é introduzir uma versão culturalmente adaptada do mnemonic SNNOOP10 para o português, denominada “NÃO É PRIMÁRIA” (“IT IS NOT PRIMARY”), para uso por profissionais de saúde em contexto de língua portuguesa.",{"name":111,"@type":102,"acceptedAnswer":112},"Como os autores adaptaram o SNNOOP10 para formar o acrônimo “NÃO É PRIMÁRIA”?",{"text":113,"@type":105},"Os autores reorganizaram as 15 “red flags” do SNNOOP10 por agrupamento semântico dos itens relacionados, associando cada letra a um elemento clínico correspondente e mapeando as red flags originais em cada letra do novo acrônimo. Também foram desenvolvidos uma tabela comparativa e uma imagem para clareza.","https://schema.org",{"og:url":75,"og:type":116,"og:title":55,"og:site_name":88,"og:description":57},"article",{"robots":118,"canonical":75},"index,follow",{"doc_id":120,"site_id":52},438587,1790685802,{"code":4,"msg":5,"data":123},{"doc_id":120,"user_id":124,"nickname":85,"user_avatar":125,"doc_module":4,"category_id":42,"category_name":43,"doc_title":55,"doc_description":57,"doc_content":126,"file_id":127,"file_url":128,"file_type":129,"file_size":130,"view_count":4,"is_deleted":4,"is_public":67,"is_downloadable":67,"audit_status":67,"page_count":131,"language":132,"language_code":53,"site_id":52,"html_lang":53,"table_of_contents":133,"faqs":134,"seo_title":135,"seo_description":57,"update_tm":121,"read_time":136},549758146520,"https://ap-avatar.wpscdn.com/avatar/80002397d8c0411e94?_k=1775819394049821470","Article published online: 2025-12-08  \nReview Article 1  \n“NÃO É PRIMÁRIA”: a Portuguese version of the SNNOOP10 mnemonic  \nDavi Coutinho Marcelino Guerra Leone 1 Antonio Fernando Soares Menezes Segundo2 Alex T. Meira 1  \n1 Universidade Federal da Paraíba, Centro de Ciências Médicas, Departamento de Medicina Interna, Serviç o de Neurologia, João Pessoa PB, Brazil.  \n2 Afya Faculdade de Ciências Médicas da Paraíba, João Pessoa PB, Brazil. Arq. Neuro-Psiquiatr. 2025;83(12):s00451813240 .  \nAddress for correspondence Davi Leone (email: [dcmg.leone@gmail.com](dcmg.leone@gmail.com))  \nAbstract  \nKeywords  \n► Headache  \n► Neurologic Examination  \n► Secondary Headache Disorders  \n► Neuroimaging  \nBackground 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.  \nObjective To introduce a culturally-adapted version of the SNNOOP10 mnemonic in Portuguese: “NÃO É PRIMÁRIA” (“IT IS NOT PRIMARY”) .  \nMethods 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.  \nResults The new mnemonic covers all reorganized items of the SNNOOP10 adapted for Portuguese speakers.  \nConclusion “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.  \nINTRODUCTION  \nSecondary headaches result from underlying pathologiesand are associated with significant morbidity and mortality. Early and accurate diagnosis is essential and primarily based on a thorough clinical history and detailed physical examination, both of which aim to identify red flags indicative of a secondary etiology.1 A cross-sectional study conducted in Brazil,2 based on the criteria stablished on the International  \nreceived  \nMay 29, 2025  \nreceived in its final form September 17, 2025 accepted  \nSeptember 18, 2025  \nDOI [https://doi.org/](https://doi.org/)[ ](https://doi.org/)10.1055/s-0045-1813240 . ISSN 0004-282X.  \nEditor-in-Chief: Hélio A. G. Teive.  \nAssociate Editor: Pedro André Kowacs.  \nClassification of Headache Disorders, second edition (ICHD- 2), identified medication overuse as the most prevalent cause of secondary headache, accounting for 16.6% of the cases. Similarly, a Brazilian multicenter, longitudinal, and observational study3 reported a prevalence of 14 . 7% of secondary headaches, with medication overuse again being the most common cause (7. 1%) .  \nThe third edition of the ICHD (ICHD-3) updated the diagnostic criteria for secondary headaches, enabling  \n© 2025 . The Author(s) .  \nThis 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/](https://creativecommons.org/licenses/by/4.0/))  \nThieme Revinter Publicações Ltda. , Rua Rego Freitas, 175, loja 1, República, São Paulo, SP, CEP 01220-010, Brazil  \n2 A Portuguese version of the SNNOOP10 mnemonic Leone et al.  \nTable 1 General diagnostic criteria for the secondary headaches of the ICHD-3  \n\n| A. Any headache fulfilling criterion C |  |\n| -","cbCaiuuiewKIX2aP","https://ap.wps.com/l/cbCaiuuiewKIX2aP","pdf",3662972,7,"Portuguese","# Abstract\n# Background\n# Objective\n# Methods\n# Results\n# Conclusion\n# Introduction\n## Secondary headaches and red flags\n## SNNOOP10 mnemonic and limitations","[{\"question\":\"O que são as cefaleias secundárias e por que reconhecer “sinais de alerta” é importante?\",\"answer\":\"As cefaleias secundárias decorrem de condições médicas subjacentes e se associam a morbidade e mortalidade significativas. O reconhecimento precoce baseia-se em história clínica e exame físico detalhados para identificar sinais de alerta indicativos de etiologia secundária.\"},{\"question\":\"Qual é o objetivo do estudo “NÃO É PRIMÁRIA”?\",\"answer\":\"O objetivo é introduzir uma versão culturalmente adaptada do mnemonic SNNOOP10 para o português, denominada “NÃO É PRIMÁRIA” (“IT IS NOT PRIMARY”), para uso por profissionais de saúde em contexto de língua portuguesa.\"},{\"question\":\"Como os autores adaptaram o SNNOOP10 para formar o acrônimo “NÃO É PRIMÁRIA”?\",\"answer\":\"Os autores reorganizaram as 15 “red flags” do SNNOOP10 por agrupamento semântico dos itens relacionados, associando cada letra a um elemento clínico correspondente e mapeando as red flags originais em cada letra do novo acrônimo. Também foram desenvolvidos uma tabela comparativa e uma imagem para clareza.\"}]","“NÃO É PRIMÁRIA” - a Portuguese version of the SNNOOP10 mnemonic | PDF",11]