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Approach to a patient with  headache Dr. Abdul Mottalib Sarker Medicine unit 2 RMCH
, ,[object Object]
Pain Sensitivity of Cranial Structures ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Pain-Sensitive Pain-Insensitive
Overall Approach Chief Complaint: Headache Headache Alarms Evidence of serious headache disorder by history or physical exam Diagnosis of Primary Headache Disorder   Work-up to identify/exclude secondary headache etiology Treat Primary Headache NO YES YES NO Consider work-up for secondary headache
General Mechanisms of Headache ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Epidemiology ,[object Object],[object Object],[object Object]
Epidemiology ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Primary Headache Lifetime Prevalence ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Secondary Headache
Headache in the ED ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Primary Headache ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Secondary Headache Leicht M, Ann Emerg Med 1980;9:404
Primary Headache Migraine Tension Cluster
Tension Headache ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],International Headache Society Diagnostic Criteria
Migraine Without Aura ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],International Headache Society Diagnostic Criteria
Migraine With Aura ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],International Headache Society Diagnostic Criteria
Cluster Headache ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],International Headache Society Diagnostic Criteria
Secondary Headache ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Secondary Headache ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Secondary Headache ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Overall Approach Chief Complaint: Headache Headache Alarms Evidence of serious headache disorder by history or physical exam Diagnosis of Primary Headache Disorder   Work-up to identify/exclude secondary headache etiology Treat Primary Headache NO YES YES NO Consider work-up for secondary headache
History ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
History ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
History ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
History ,[object Object],[object Object],[object Object],[object Object]
Physical Exam ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
investigation ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Diagnostic Alarms ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Overall Approach Chief Complaint: Headache Headache Alarms Evidence of serious headache disorder by history or physical exam Diagnosis of Primary Headache Disorder   Work-up to identify/exclude secondary headache etiology Treat Primary Headache NO YES YES NO Consider work-up for secondary headache
ED Treatment of Primary Headache ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Prophylaxis Treatment of Primary Headache ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Overall Approach Chief Complaint: Headache Headache Alarms Evidence of serious headache disorder by history or physical exam Diagnosis of Primary Headache Disorder   Work-up to identify/exclude secondary headache etiology Treat Primary Headache NO YES YES NO Consider work-up for secondary headache
Diagnostic Studies ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Subarachnoid Hemorrhage ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Temporal Arteritis ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Overall Approach Chief Complaint: Headache Headache Alarms Evidence of serious headache disorder by history or physical exam Diagnosis of Primary Headache Disorder   Work-up to identify/exclude secondary headache etiology Treat Primary Headache NO YES YES NO Consider work-up for secondary headache

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Headache

  • 1. Approach to a patient with headache Dr. Abdul Mottalib Sarker Medicine unit 2 RMCH
  • 2.
  • 3.
  • 4. Overall Approach Chief Complaint: Headache Headache Alarms Evidence of serious headache disorder by history or physical exam Diagnosis of Primary Headache Disorder Work-up to identify/exclude secondary headache etiology Treat Primary Headache NO YES YES NO Consider work-up for secondary headache
  • 5.
  • 6.
  • 7.
  • 8.
  • 9. Primary Headache Migraine Tension Cluster
  • 10.
  • 11.
  • 12.
  • 13.
  • 14.
  • 15.
  • 16.
  • 17. Overall Approach Chief Complaint: Headache Headache Alarms Evidence of serious headache disorder by history or physical exam Diagnosis of Primary Headache Disorder Work-up to identify/exclude secondary headache etiology Treat Primary Headache NO YES YES NO Consider work-up for secondary headache
  • 18.
  • 19.
  • 20.
  • 21.
  • 22.
  • 23.
  • 24.
  • 25. Overall Approach Chief Complaint: Headache Headache Alarms Evidence of serious headache disorder by history or physical exam Diagnosis of Primary Headache Disorder Work-up to identify/exclude secondary headache etiology Treat Primary Headache NO YES YES NO Consider work-up for secondary headache
  • 26.
  • 27.
  • 28. Overall Approach Chief Complaint: Headache Headache Alarms Evidence of serious headache disorder by history or physical exam Diagnosis of Primary Headache Disorder Work-up to identify/exclude secondary headache etiology Treat Primary Headache NO YES YES NO Consider work-up for secondary headache
  • 29.
  • 30.
  • 31.
  • 32. Overall Approach Chief Complaint: Headache Headache Alarms Evidence of serious headache disorder by history or physical exam Diagnosis of Primary Headache Disorder Work-up to identify/exclude secondary headache etiology Treat Primary Headache NO YES YES NO Consider work-up for secondary headache

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