Topic Info - BotMed Application

TopicName

Headache

ClinicalTests

CBC (anemia);
TSH (hypothyroid can make HA worse);
ESR, CRP (check inflammation, temporal artery);
Lumbar puncture (LP) with CSF analysis (cell count, protein, glucose,
Gram stain, PCR for specific pathogens, culture): meningitis;

ImagingStudies

CT head without IV contrast.
Doppler U/S - carotid artery 
Tonometry: if increased intraocular pressure is suspected;
EEG: for any form of suspected seizures or complex migraine;
Temporal artery biopsy: if GCA is suspected;

PhysicalExams

Vital signs (Fever, high BP);
Inspection and palpation of entire head (trauma);
ENT inspection; including funduscopic
exam;
complete neurologic exam.

Comment

ER VISIT:
Eye: glaucoma, uveitis, cluster;
Recurrent(chronic): migrain, tension, TMJ, cervical OA;
Vascular: SAH, ICH, temporal arteritis;
Infections: meningitis, encephalitis, systemic infection, sinusitis;
Systemic: anemia, anoxia, carbon monoxide poisoning, pre-eclampsia;
Intracranial pressure: tumor, abscess, HTN, pseudotumor cerebri;
Trauma: concussion, subdural hematoma, epidural bleeding;

Onset (acute vs. chronic), location (unilateral vs. bilateral), quality (dull vs. stabbing), intensity (is it the “worst headache of their life”?), duration, timing (does it disturb sleep?), presence of associated neurologic symptoms (paresthesias, visual stigmata, weakness, numbness, ataxia, photophobia, dizziness, auras, neck stiffness); nausea/vomiting, jaw claudication, recent trauma, dental surgery, sinusitis symptoms; exacerbating factors (stress, fatigue, menses, exercise, certain foods) and alleviating factors (rest, medications); patient and family history of headache; history of trauma.

WebLink

https://www.aafp.org/afp/2014/0415/p642.html | https://www.aafp.org/afp/2011/0201/p271.html