This document provides an overview of evaluating and treating patients presenting with headache. It describes the approach of determining if the headache is due to a primary or secondary cause through history, physical exam, and diagnostic testing. Primary headaches include tension, migraine and cluster headaches and are treated differently than secondary headaches which require identifying and treating their underlying cause.

1. Approach to a patient with headache Dr. Abdul Mottalib Sarker Medicine unit 2 RMCH

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

9. Primary Headache Migraine Tension Cluster

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

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

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

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