Headache
AT N T WIRELESS
A
Aura
T
Tearing
N
Nousea/Vomiting
W
Weakness/Numbness/Weight change
I
Injury
R
Runny nose
E
Estrogen exposure (OCPs)
L
Leg/ Jaw/ Joint pain
E
Energy level
S
Stress
S
Speech difficulties
PHYSICAL EXAMINATION for Headache:
HEENT:
Palpation of the Sinuses & Temporomandibular joints, Funduscopic exam, Nose, Mouth< Teeth & Throat, Neck Examination: Inspection, palpation
Cardiovascular exam:
Auscultation
Pulmonary exam:
Auscultation
Neurology exam:
CN 2-12, Muscle strength, DTRs, Kernig’s sign & Brudzinskisign
DIFFERENTIAL DIAGNOSIS for Headache:
Migraine headache:
Unilateral headache, Visual disturbance, photophobia, flash light, N/V, trigger by chocolate, alcohol and cheese.
Tension headache:
Bilateral sqeezing headache, associated with stress in his/her life, no visual disturbances,
Cluster headache:
Unilateral headache, associated with red, tearing eye, rhinorrhea and nasal stuffiness.
Pseudotumor cerebri:
Severe headache, N/V, associated with obesity, vitamin A toxcity, OCPs
Meningitis:
headache, fatigue, fever, lethargy, loss of appetite, N/V, blotchy rashes or red rashes, neck stiffness confusion, photophobia
Sinusitis:
Headache, nasal discharge, fatigue, fever.
Temporal arteritis (Giant cell arteritis):
Unilateral headache, shoulder pain, jaw pain with chewing
Subarachnoid hemorrhage:
severe headache, confusion, N/V,
Introcranial mass:
Severe headache, N/V, weight loss, double vision,
DIAGNOSTIC WORKUP for Headache:
CBC
ESR
CT of head
MRI
Lumbar puncture
CT of Sinuses