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Evaluation of Headache Dr. Mohammed Tahir Kurmanji  Neurologist FICMS University of Suleimania Department of Neurology
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]
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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Medicine 5th year, 1st lecture (Dr. Mohammed Tahir)

  • 1. Evaluation of Headache Dr. Mohammed Tahir Kurmanji Neurologist FICMS University of Suleimania Department of Neurology
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  • 3. 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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  • 8. Primary Headache Migraine Tension Cluster
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  • 16. 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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  • 23. 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
  • 24.
  • 25.
  • 26. 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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  • 30. 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