1. EVALUATION OF PATIENT
WITH HEADACHE
GROUP F6 – CASE SCENARIO 2 STUDENTS:
17231
-
‫هبة‬
‫المرغني‬ ‫حسين‬ ‫فائز‬
17234
-
‫منذر‬
‫درمان‬ ‫سعد‬ ‫أحمد‬
17235
-
‫مكرم‬
‫محمود‬ ‫امراجع‬ ‫فيصل‬
17236
-
‫مصعب‬
‫نتفه‬ ‫عبدهللا‬ ‫جمال‬
17238
-
‫أميرة‬
‫أحمد‬ ‫عبدالرحمن‬ ‫جمال‬
17242
-
‫قمر‬
‫رسالن‬ ‫عبدالستار‬ ‫سامر‬

2. DEFINITION :
Headache is a type of pain or discomfort in the head or neck region
that’s described as a sense of pressure, throbbing, constant, sharp or
dull in nature.
They can vary in intensity, duration and location, and can be
accompanied by other symptoms like: Nausea, Sensitivity to light/sound
and/or dizziness
While most headaches are not dangerous, certain types can be a sign
of a more serious condition

3. CLASSIFICATION:
• There are many different types of
headache, such as (Tension
Headache, Cluster Headaches, Sinus
Headaches, Migraines) and others.

4. ETIOLOGY OF HEADACHE:
• It can be a primary disorder or secondary to pathology.
1) Primary Headache Disorders include:
- Migraine, Tension Type, Trigeminal Autonomic Cephalgias (Includes
Cluster Headaches)
2) Secondary Headache Disorders include:
has numerous causes, ex: Extracranial (Dental Disorders) / Intracranial
(Tumors) / Systemic (Viral Infections) / Medications (Hormone Therapy,
Analgesic Overuse)
and Dehydration.

5. EXAMINATION SEQUENCE:
• Mental Status Higher Function
Cranial Nerve Examination
Motor System Evaluation
Sensory System Evaluation
Reflex Testing
Coordination Test

6. HISTORY TAKING:
Onset : Gradual (Space Occupying Lesion), Sudden (Subarachnoid
Hemorrhage)
Duration: Few Days (Meningitis, Migraine), Weeks (Increased ICP)
Site: Unilateral (Migraine), Bilateral (Tension, S.A.H)
Severity: Moderate (Tension), Severe (Migraine), Explosive (S.A.H)
Course: Recurrent (Migraine)
Character: Dull/Throbbing (Migraine), Tight/Pressure (Tension)
Aggravating: Emotions (Tension), Bright light/Noise/Odor (Migraine),
Bending/Coughing (ICP)
Relieving: NSAIDs and Acetaminophen
Vomiting/Blurry Vision (ICP)
Nausea/Vomiting/Photophobia
(Migraine)
Fever/Photophobia (Meningitis)

7. HISTORY TAKING:
Past Medical:
Ear/Eye Infection
(Sinusitis, Intracranial Abscess)
C.A.D (by usage of Nitrates)
Brain Malignancy Metastasis
Past Surgical:
Head Injuries (from few
days/weeks)
Hemorrhage
Family History:
any history of Migraine
Epilepsy
Subarachnoid
Hemorrhage
Drug History:
Allergy, Chronic drug usage (Dose + Side
Effects)
Social History:
Smoking, Caffeine Consumption,
Occupation

8. DIAGNOSIS DX:
• CBC / Urinalysis : to exclude (DM, Thyroid Dysfunction, Blood
Infections)
CT Scan / MRI / X-Ray / Eye Examination : (for any Trauma or
Tumors)
Spinal Tap : (the removal of fluid from the spine, it looks for
conditions such as infections of the brain and spinal cord)

9. MANAGEMENT:
• According to the type of Headache, General Management
include
Proper Hydration, Magnesium Supplements (block signals from
brain)
Adequate Sleep, Caffeine, avoiding bright light, etc…
1) Migraine Headaches:
Moderate (NSAIDs +
Acetaminophen)
Severe (Triptans 5HT1-Receptor
Agonist)
2) Tension Headaches:
NSAIDs + Acetaminophen +
Diclofenac
4) Cluster Headaches:
Sumatriptans (SSRA) / CCB
(Verapamil)
3) Sinus Headaches:
Antihistamines
(Allergy)
Antibiotics
(Inflammation)
NSAIDs (as Analgesia)
5) Hypertension Headaches:
Aspirin (Considered to be the Safest
Option)

10. PREVENTION:
Making lifestyle changes can help reduce the frequency and
severity of headaches.
These changes can include avoiding triggers, getting regular
exercise, reducing stress and eating a healthy diet.
It is also important to get enough sleep and practice good sleep
hygiene.
Taking breaks from screens and engaging in relaxing activities
can also help reduce stress and prevent headaches.

11. THANK YOU FOR YOUR TIME
• Any questions?