Headaches Clinical Guide

Headache is one of the most common patient complaints. This chapter will familiarize you with the International Classification of Headache Disorders and the possible causes of headache pain. We then review the diagnosis of three key primary headache types including migraines, tension headaches, and cluster headaches, and briefly review other primary headache disorders and chronic daily headaches.

Secondary headaches are classified into eight broad categories. In these articles we’ll review how to diagnose a number of common secondary headaches which include sinus headaches, headaches from musculoskeletal pain or temporomandibular joint (TMJ) issues, cranial neuralgias, and analgesic overuse headaches. Most importantly, we’ll summarize concerning red flag symptoms and the ominous headache syndromes that require immediate intervention. We’ll also take a look at underlying medical conditions that can also cause secondary headaches.

In the articles of this chapter we delve deeper into the essential details for mastering the diagnosis of headaches. We’ll walk you through characterizing your patient’s headaches by asking the appropriate questions and taking a great headache history. We’ll then look at using a headache diary to help your patient identify food and non-food triggers of headaches.

Every headache patient will require a full neurological examination. In these articles we’ll briefly cover the components of a complete neurological exam and we’ll look at possible neurological abnormalities that might be found upon examination. We’ll also review when it is appropriate to send your headache patient for imaging or further testing.

Once you accurately diagnose your headache patient, they’ll require a comprehensive treatment plan. In these articles we’ll review what you need to know about non-pharmacologic management, prophylactic medication, abortive medication, and rescue medications. We’ll wrap up this Headaches Clinical Guide by reviewing some patient cases where we’ll walk you through history taking, diagnosis, and treatment.