Headache Flashcards
1
Q
History
A
We all get headaches - why is this different Explain the type of pain Duration Onset sudden or gradual Timing - all time or on wakening etc Triggers\Movement Fluid/ alcohol caffeine Nausea/vomiting Rash Neck pain Neurological - vision disturbance, taste, smell Scalp/temporal tenderness Head injury Location - unilateral- pulsating/throbbing in migraine Stress Medications (particularly new) Last time saw optician
2
Q
Examination
A
TPR BP Neck stiffness Palpate temporal arteries ? Cranial nerves
3
Q
Red flags
A
Previous cancer New onset over 50 First migraine over 40 Sudden onset - thunderclap Recent head injury Meningitis symptoms Eye pain Headache on wakening Worsening/persistent Eye pain Carbon monoxide poisoning
4
Q
Management
A
Simple analgesics Stress relief Increase fluids/regular meals Sleep hygiene Headache diary Avoid codeine
Prescribe - paracetamol soluble
Safety netting if worse etc.
