Headache

Objectives

  1. Through a focused history and physical examination, be able to efficiently differentiate between common benign headaches and the uncommon ominous headache that warrrants additional work-up.
  2. Be able to explain to the patient your understanding of the source of the headache in words that the patient can understand and that is reassuring to the patient.
  3. Be able to offer the patient appropriate treatment and empathy, taking into consideration the medication cost and effect on the patient's life.


General Comments

Pathophysiology
Classification of Headache
Acute headaches are those that appear suddenly, often without prior history. Causes: cellulitis of the scalp, sinusitis, arteritis, severe muscle spasm, acute distension of an aneurysm, subarachnoid bleeding, meningitis, encephalitis.

Recurring headaches may be due to a chronic cause, such as emotional depression and tension, or may be the result of a migraine process.

In patients with headache of a more prolonged time course, it is important to note any changes in the quality and severity of the pain and in the appearance of associated neurologic signs.
Diagnostic Approach
Therapeutic Measures

D.L. Powell, MD
updated 6/22/04


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