Podcast
Questions and Answers
Which of the following is a less common acute primary headache disorder?
Which of the following is a less common acute primary headache disorder?
- Benign exertional headache (correct)
- Tension-type headache
- Cluster headache
- Migraine with aura
What is the primary task of the family physician in evaluating headaches?
What is the primary task of the family physician in evaluating headaches?
- Managing cluster headaches
- Diagnosing migraine with aura
- Identifying tension-type headaches
- Ruling out potentially life-threatening causes (correct)
According to the text, who coordinates the series of articles on 'Problem-Oriented Diagnosis'?
According to the text, who coordinates the series of articles on 'Problem-Oriented Diagnosis'?
- Department of Neurology at the Uniformed Services University of the Health Sciences
- International Headache Society
- Cephalalgia Committee
- Department of Family Medicine at the Uniformed Services University of the Health Sciences (correct)
Which publication is the text adapted from for the classification and diagnostic criteria for headache disorders?
Which publication is the text adapted from for the classification and diagnostic criteria for headache disorders?
What is the preferred imaging modality to identify acute hemorrhage?
What is the preferred imaging modality to identify acute hemorrhage?
Which imaging modality is generally more available?
Which imaging modality is generally more available?
What is the percentage of abnormalities noted on CT scans that potentially benefit from neurosurgical intervention?
What is the percentage of abnormalities noted on CT scans that potentially benefit from neurosurgical intervention?
According to the U.S. Headache Consortium guidelines, when should neuroimaging be considered in patients with non-acute headache?
According to the U.S. Headache Consortium guidelines, when should neuroimaging be considered in patients with non-acute headache?
What is the preferred initial imaging approach to rule out subarachnoid hemorrhage within the first 48 hours?
What is the preferred initial imaging approach to rule out subarachnoid hemorrhage within the first 48 hours?
What does xanthochromia in the CSF indicate?
What does xanthochromia in the CSF indicate?
What is the significance of lumbar puncture in assessing the CSF?
What is the significance of lumbar puncture in assessing the CSF?
According to the National Headache Foundation, what is the role of EEG in the evaluation of headaches?
According to the National Headache Foundation, what is the role of EEG in the evaluation of headaches?
What is the CSF pressure associated with headaches related to CSF hypotension?
What is the CSF pressure associated with headaches related to CSF hypotension?
According to the National Headache Foundation, when is routine use of EEG in the evaluation of headaches warranted?
According to the National Headache Foundation, when is routine use of EEG in the evaluation of headaches warranted?
What are the Grade A recommendations of the U.S. Headache Consortium based on?
What are the Grade A recommendations of the U.S. Headache Consortium based on?
When is lumbar puncture preferred according to the text?
When is lumbar puncture preferred according to the text?
Which type of headache is usually recurrent and has no organic disease as its cause?
Which type of headache is usually recurrent and has no organic disease as its cause?
What is a red flag for consideration of a secondary headache disorder?
What is a red flag for consideration of a secondary headache disorder?
What warrants lumbar puncture with cerebrospinal fluid analysis and pressure measurement?
What warrants lumbar puncture with cerebrospinal fluid analysis and pressure measurement?
What is crucial to determining the etiology of a headache?
What is crucial to determining the etiology of a headache?
Which type of headache is associated with signs of systemic illness, focal neurologic signs, or symptoms of disease?
Which type of headache is associated with signs of systemic illness, focal neurologic signs, or symptoms of disease?
What are the red flags in the evaluation of acute headaches in adults?
What are the red flags in the evaluation of acute headaches in adults?
What is used for the diagnosis and preliminary classification of the headache type?
What is used for the diagnosis and preliminary classification of the headache type?
What is mandatory for the diagnosis and preliminary classification of the headache type?
What is mandatory for the diagnosis and preliminary classification of the headache type?
What are specific work-ups that may be necessary based on red flags identified in the evaluation of acute headaches in adults?
What are specific work-ups that may be necessary based on red flags identified in the evaluation of acute headaches in adults?
What is included in the approach to the headache history?
What is included in the approach to the headache history?
What type of headache is a recurrent headache with no organic disease as its cause?
What type of headache is a recurrent headache with no organic disease as its cause?
What is used for the diagnosis and preliminary classification of the headache type?
What is used for the diagnosis and preliminary classification of the headache type?
Which type of headaches are strictly unilateral?
Which type of headaches are strictly unilateral?
What is a red flag indicating serious underlying conditions in headaches?
What is a red flag indicating serious underlying conditions in headaches?
What type of headache is usually band-like and bilateral?
What type of headache is usually band-like and bilateral?
In which patients should limited laboratory testing include a complete blood count for suspected infection?
In which patients should limited laboratory testing include a complete blood count for suspected infection?
What is characterized by specific criteria including a free interval of less than 60 minutes between aura and headache?
What is characterized by specific criteria including a free interval of less than 60 minutes between aura and headache?
What type of headaches generally begin unilaterally but may progress?
What type of headaches generally begin unilaterally but may progress?
When should neuroimaging, such as CT scanning or MRI, be considered in the evaluation of adult patients with acute headache disorders?
When should neuroimaging, such as CT scanning or MRI, be considered in the evaluation of adult patients with acute headache disorders?
What did a study find regarding the ordering of CT scans for patients with headache?
What did a study find regarding the ordering of CT scans for patients with headache?
What type of headache is characterized by fully reversible aura symptoms and a gradual development of symptoms?
What type of headache is characterized by fully reversible aura symptoms and a gradual development of symptoms?
What did C. Randal Clinch, D.O., emphasize as 'red flags' warranting additional evaluation?
What did C. Randal Clinch, D.O., emphasize as 'red flags' warranting additional evaluation?
When should referral to a headache subspecialist be considered?
When should referral to a headache subspecialist be considered?
What is the evidence regarding the concern for brain tumors when ordering CT scans for headaches?
What is the evidence regarding the concern for brain tumors when ordering CT scans for headaches?
Which type of headache is characterized by fully reversible aura symptoms and a gradual development of symptoms?
Which type of headache is characterized by fully reversible aura symptoms and a gradual development of symptoms?
What is the significance of lumbar puncture in assessing the CSF?
What is the significance of lumbar puncture in assessing the CSF?
What are specific signs associated with cluster headaches?
What are specific signs associated with cluster headaches?
What is used for the diagnosis and preliminary classification of the headache type?
What is used for the diagnosis and preliminary classification of the headache type?
What is the preferred initial imaging approach to rule out subarachnoid hemorrhage within the first 48 hours?
What is the preferred initial imaging approach to rule out subarachnoid hemorrhage within the first 48 hours?
What is the primary task of the family physician in evaluating headaches?
What is the primary task of the family physician in evaluating headaches?
What is the percentage of abnormalities noted on CT scans that potentially benefit from neurosurgical intervention?
What is the percentage of abnormalities noted on CT scans that potentially benefit from neurosurgical intervention?
What are specific symptoms that may indicate a potentially life-threatening secondary headache disorder?
What are specific symptoms that may indicate a potentially life-threatening secondary headache disorder?
When should lumbar puncture with cerebrospinal fluid analysis and pressure measurement be warranted?
When should lumbar puncture with cerebrospinal fluid analysis and pressure measurement be warranted?
What is the role of EEG in the evaluation of headaches according to the National Headache Foundation?
What is the role of EEG in the evaluation of headaches according to the National Headache Foundation?
What is the preferred imaging modality to identify acute hemorrhage?
What is the preferred imaging modality to identify acute hemorrhage?
What warrants referral to a headache subspecialist according to the text?
What warrants referral to a headache subspecialist according to the text?
Which type of headache is strictly unilateral?
Which type of headache is strictly unilateral?
What may symptoms like diplopia, stiff neck, and unilateral weakness indicate?
What may symptoms like diplopia, stiff neck, and unilateral weakness indicate?
What type of headache can be triggered by head trauma?
What type of headache can be triggered by head trauma?
Which headache disorder is characterized by signs like conjunctival injection, lacrimation, and nasal congestion?
Which headache disorder is characterized by signs like conjunctival injection, lacrimation, and nasal congestion?
What type of headache lasts from 30 minutes to 7 days?
What type of headache lasts from 30 minutes to 7 days?
What type of headache is crucial to distinguish from primary and secondary headache disorders?
What type of headache is crucial to distinguish from primary and secondary headache disorders?
What characteristics can further classify the headache as migraine, tension-type, or cluster?
What characteristics can further classify the headache as migraine, tension-type, or cluster?
What may indicate potentially life-threatening secondary headache disorder?
What may indicate potentially life-threatening secondary headache disorder?
What might headache subsequent to trauma signify?
What might headache subsequent to trauma signify?
What should be reviewed as they can trigger drug-rebound and nonspecific headaches?
What should be reviewed as they can trigger drug-rebound and nonspecific headaches?
What may headache subsequent to trauma signify?
What may headache subsequent to trauma signify?
What type of headache is associated with common medical procedures like lumbar puncture?
What type of headache is associated with common medical procedures like lumbar puncture?
Study Notes
Emergency Department Evaluation of Headache
- Patients complaining of first or worst headache of any age require evaluation.
- It is crucial to distinguish between primary and secondary headache disorders based on the patient's symptoms.
- Symptoms such as diplopia, stiff neck, disorientation, rash, fever, and unilateral weakness may indicate a potentially life-threatening secondary headache disorder.
- Onset of headache should be assessed for sudden, severe onset which may indicate secondary headache disorders like subarachnoid hemorrhage or vascular malformations.
- Location of pain and radiation should be determined, as cluster headaches are strictly unilateral, tension-type headaches are usually bilateral, and migraines may start unilaterally but progress.
- Quality of pain, whether throbbing, stabbing, dull, or pressure-like, can further classify the headache as migraine, tension-type, or cluster.
- Patients with concurrent medical conditions like HIV infection or cancer are more likely to have an organic cause of headache, such as meningitis, CNS lymphoma, or intracranial vascular disorder.
- Medications, both prescription and over-the-counter, should be reviewed as they can trigger drug-rebound and nonspecific headaches.
- Headache subsequent to trauma may signify a postconcussive disorder, and it's essential to suspect intracranial hemorrhage.
- Migraine and cluster headaches can be triggered by head trauma, and headaches have been associated with common medical procedures like lumbar puncture.
- Cluster headaches are characterized by severe unilateral orbital, supraorbital, or temporal pain associated with signs like conjunctival injection, lacrimation, and nasal congestion.
- Tension-type headaches are characterized by headache lasting from 30 minutes to 7 days, with specific pain characteristics and absence of nausea or vomiting.
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Description
Test your knowledge of headache evaluation and diagnosis with this quiz. Learn about different types of headaches, red flags for serious underlying conditions, and the importance of distinguishing between primary and secondary headache disorders. Explore the criteria for diagnosing secondary headaches and the indications for neuroimaging.
