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Headaches A
Headaches
Type | Age/Sex | Site | Characteristics | Provoked by | Lab/Test |
---|---|---|---|---|---|
Common Migraine | Childhood & Early Adulthood. Females | Generally Unilateral | Throbbing, photophobia, phonophobia, worse behind one eye, nausea and/or vomiting, familial, pregnancy | Bright light, chocolate, cheese, tension, red wine, menstrual cycle | None |
Classic Migraine | Same as Common | Same as Common | Same as Common + AURA | Same as Common | None |
Hypertension | Adult | Occipital & Vertex | Throbbing, wake up with headache | None | Blood pressure, Lipid profile |
Cluster (aka Histamine Headache) | Adolescent to adults. Males | Unilateral. Orbital & Temporal | Stabbing, wake up with headache, ptosis, miosis, red eye, tearing, runny nose & nasal congestion | Alcohol | None |
Tension | Any age | Band-like | Pressure, muscle tightness, neck pain | Tension, stress, work, fatigue | None |
Temporal Arteritis (Giant Cell) | Over 50 years old | Unilateral. Temporal | Throbbing, persistent burning, aching, possible loss or change in vision, if you see neck & shoulder pain with stiffness -> change Dx to Polymyalgia Rheumatica | Sensitive scalp, tender arteries | ESR elevated, Biopsy |
Cervicogenic (aka Vertebrogenic) | Adult | Occipital & Upper Cervical | Neck pain referred to head, decreased ROM in upper cervical and occiput, worsened with certain neck movements | Head movement | Flexion/Extension Views |
Sinus | Any age | Localized & changes with body position | Steady throb, local tenderness, worse in the morning, pain worse with bending forward or with lying down, sensitive to temperature changes, nasal discharge, sore throat, possible fever and fatigue | Chronic sinusitis | None |
Subarachnoid Hemorrhage | Any age | Basilar area | Abrupt onset, constant, stiff neck, excruciating pain like never before experienced, usually described as the "worst headache ever", confusion, slurred speech, nausea, vomiting, paralysis, hemiplegia, | Hypertension, stress | Send to ER, high blood pressure, fever |
Subdural Hematoma | Any age | None | Slow bleed following trauma, symptoms evident days-weeks post injury | Trauma | Send to ER |
Brain Tumor | Any age | Any place & changes with body position | Onset morning & evening, mild to severe, throbbing, neck stiffness worse than ever, progressively worse, pain worse in morning, pain wakes up patient at night, personality behavioral changes, visual changes, nausea, vomiting, memory problems | Tumor growth | None |
Meningeal Irritation | Any age | Stiff neck | Photophobia, fever, nuchal rigidity, sever head pain, throbbing, nausea, vomiting, confusion | Worse in flexion | Kernig/Brudzinski, CSF tap |
Hypoglycemic | Generalized | Skipping meals | FBS | ||
Post Concussive | Any age | Localized general pain | Loss of memory, visual disturbances | Fall, MVA, whiplash injury, trauma | Refer to Neurologist/ER |
TMJ/Interarticular Dysfunction | Any age | TMJ Joint | Clicking when opening and closing mouth, dental work for > 2hrs | Refer to Dentist | |
Caffeine Withdrawal | Bilateral | Pulsating | Daily intake of coffee is either stopped or delayed | ||
Eyestrain | Bilateral. Frontal | Straining of the eyes |