Other features which suggest a specific source of headache pain include the following:
Fig.1 : AcuteManagement of Headache
What is the reason for presentation?
The patient can no longer tolerate
The headache is either:
Their typical recurrent headaches
1. The first headache of significant severity (or)
2. Sufficiently different or severe to alarm the patient.
Obtain history and neurologic exam Obtain history and neurologic exam
History typical Atypical history or Features suggestive of a focal or infectious for migraine or focal abnormality on lesion luster headache neurological exam and normal exam
1. Headache of sudden rapid onset
2. Onset during exertion
3. History of altered mental status
4. Posterior radiation of headache
5. First severe headache after 35
6. Prior or coexistent infectious disease
Abortive therapy and observe Patient responds: Patient does not respond:
Probably primary duration > 48 hours;
headache, referral for evidence of dehydration
1. Nuchal rigidity long-term treatment or electrolyte disturbance
2. Toxic appearance or fever (even low of headaches. from prolonged vomiting grade)
4. Any localizing or lateralizing abnor- mality 5. Decreased mental status.
Proceed to Next Figure
Aches associated with chronic nausea require a work-up to rule out raised intracranial pressure
Sudden, severe, unilateral vision loss is suggestive of optic neuritis
Headache, fatigue, generalized aches and pain, and night sweats in subjects age 55 or older suggest the presence of temporal arteritis
Intermittent headaches with high blood pressure is suggestive of pheochromocytoma.
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