Headache

Question 1

Recurrent, severe headache unilateral and throbbing in nature
Associated with aura, nausea and photosensitivity
In women may be associated with menstruation.

Answer 1

Migraine

Question 2

Recurrent, non-disabling, bilateral headache

often described as a ‘tight-band’

Answer 2

Tension headache

Question 3

1-2 episodes per day
lasting 15 mins - 2 hours

Intense pain around one eye
Patient is restless during an attack
Accompanied by redness, lacrimation, lid swelling

More common in men and smokers

Answer 3

Cluster Headaches

Question 4

Typically patient > 60 years old
Usually rapid onset
Unilateral headache
Jaw claudication (65%)
Tender, palpable temporal artery
Raised ESR

Answer 4

Temporal Arteritis

Question 5

Present for >15 days per month
Developed/worsened whilst taking regular symptomatic medication
Patients using opioids and triptans are at most risk
May be psychiatric co-morbidity

Answer 5

Medication overuse headache

Question 6

Other causes of single episode acute headache

Answer 6

meningitis
encephalitis
SAH
head injury
sinusitis
glaucoma (acute closed-angle)
tropical illness e.g. Malaria