Case history of the headache patients

1. Big picture

Headache is one of the most common neurological complaints. Most patients have primary headache, meaning the headache itself is the disease, such as migraine, tension-type headache, or cluster headache. A smaller but very important group has secondary headache, meaning the headache is a symptom of another disease, such as subarachnoid hemorrhage, meningitis, brain tumor, hydrocephalus, temporal arteritis, venous sinus thrombosis, glaucoma, trauma, or hypertensive emergency.

The examiner wants one main thing:

When you take the history of a headache patient, first decide whether it is primary and benign-looking or secondary and dangerous.

The key exam sentence:

The history must clarify the onset, time course, location, quality, intensity, provoking factors, associated symptoms, previous pattern, medication use, and red flags.

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