Headache Flashcards
A 23-year-old presents with incapacitating right-sided throbbing headache which was preceded by a period in which she saw flashing lights. She also has nausea, vomiting and photophobia with her headaches. Physical exam reveals no abnormalities. She says that drinking red wines and eating aged cheeses triggers these headaches. No tests were done.
Classic migraine with aura
A 23-year-old female presents with left-sided jaw pain. Her boyfriend says that she grinds her teeth at night. On examination, there is decreased opening of her jaw with a clicking sound on opening the jaw. No tests were done.
TMJ dysfunction
A 56-year-old presents with occipital headaches which are worse with rotation and left lateral bending of the neck. The headache radiates towards the left eye. On examination, there is decreased left rotation and left lateral bending of the neck. Cervical x-rays show moderate DJD mainly in C2-4 vertebra.
Cervicogenic headache
A 19-year-old male college student complains of headache and fever following a sore throat. On examination, there is neck stiffness and both Kernig’s and Brudzinski’s tests are positive. CBC shows leukocytosis with raised lymphocytes. CSF shows normal glucose and several lymphocytes.
Viral meningitis
A 13-year-old teenager complains of recurrent episodes of unilateral throbbing headache, nausea, vomiting and photophobia. There is no preceding aura. Physical exam is WNL. No lab tests were done.
Common migraine w/o aura
A 21-year-old male complains of frontal headaches. He also complains of nasal stuffiness and congestion. On examination, there is tenderness on percussion of his left frontal sinus. A Waters view of his skull shows cloudiness of his left frontal sinus.
Sinusitis
A 36-year-old male presents with severe one-sided headaches that have been recurring at the same time each day for the past five days. On examination, there is ipsilateral conjunctival redness, lacrimation and rhinorrhea. The headaches are precipitated by drinking alcohol. No labs done.
Cluster headache
A 35-year-old female complains of squeezing bitemporal headaches which occur on a daily basis and are worse in the afternoons. There is no nausea, vomiting or photophobia. There are no abnormal findings on examination. No labs done.
Tension-type headache
A 62-year-old female presents with right-sided temporal headaches that are worse with chewing. On examination, there is a swollen tender branch of the superficial temporal artery. ESR is 60 mm/hr.
Temporal arteritis
A 45-year-old man presents with pain in the back of his head between the occiput and atlas. The pain radiates to the back of his right eye. BP is normal and there is no fever, nausea or vomiting. Pressure on the occipital nerve causes pain radiating to the eye. No labs done.
Occipital neuralgia
A 40-year-old female presents with what she calls “the worst headache of my life.” She reports having been in a car accident two days ago. On examination, Kernig’s test is positive. She is also sensitive to light and has neck pain. Lumbar puncture revealed blood in the CSF.
Subarachnoid hemorrhage
