Headache History

Question 1

What are the common presenting symptoms in neurology?`

Answer 1

Headache
Transient loss of consciousness
Seizure
Stroke and TIA
Dizziness and vertigo
Functional symptoms
Motor and sensory changes

Question 2

What are important associated symptoms to ask about headaches?

Answer 2

N&V
Visual disturbance
Photophobia/phonophobia
Neck stiffness
Fever
Rash
Weight loss
Sleep disturbance (waking in the morning)
Temporal region tenderness
Neurological deficits

Question 3

What are important questions to ask about the timing of a headache?

Answer 3

Duration?
Episodic?
Clear pattern?
Worse at any time of day?

Question 4

What are the headache red flags? (there’s a lot of em)

Answer 4

Sudden onset headaches reaching max intensity by 5 mins (SAH)
Fever, meningeal irritation and mental status change (meningitis)
New onset focal neurological deficit, personality change or cognitive dysfunction
Decreased conscious level
Head trauma
Posture dependent headache
Temporal tenderness and jaw claudication
Eye problems

Question 5

What PMH questions would you ask for a headache history?

Answer 5

Previous headaches?
Previous intracranial bleeds?
Head trauma in last 3 months?
Malignancy?
Medical conditions?
Previous brain surgery?

Question 6

What 2 types of drugs should you ask about in drug history for headache?

Answer 6

Warfarin/aspirin

Painkillers