Primary Headaches Migraine –severe, one-sided, –nausea Tension-Type –milder, more diffuse, – –no nauseaCluster –brief, around the eye, –occurs in cycles
Warning Signs in Headache Warning Signs in Headache Sudden Brought on by exertion New kind of headache, or change in pattern Onset in middle age or later Fever Change in behavior or thinking Changes in sensation, strength Setting of systemic disease - eg Cancer, AIDS
Medical Evaluation of Headaches History of the HA problem General medical history General examination Diagnostic testing
Medical Evaluation History –Where, When –What Triggers, what helps –What other symptoms –Family history –Medical problems and medications
Medical Evaluation Examination –Head and Neck –General exam –Neurological exam Mental function Vision Motor function SensationCoordination
IHS Classification - 2003 IHS Primary HA 1. Migraine 2. Tension-type 3. Cluster 4. Exertional Secondary HA 5. Post-traumatic 6. Blood vessel disease 7. Brain tumor 8. Substances 9. Infection 10. Medical problems 11. Neck, Eyes, SInuses 12. Psychiatric 13. Neuralgias However – Recurring headaches are usually primary (migraine or tension-type headache)
Headache - When to see a Physician Conclusions Headache can be a warning sign of serious illness Most correctable causes of headache can be found Most headache problems are due to “primary headache”
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