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Practical evaluation and diagnosis of headache.
Semin Neurol. 1997; 17(4):307-12.SN

Abstract

Establishing an open and honest physician-patient relationship is essential for the proper evaluation and management of headache disorders. Obtaining a complete headache and medical history is the most important part of the initial diagnostic evaluation. This history should include information about headache onset, pain intensity, character of the pain, presence of aura, associated autonomic symptoms, and trigger factors. Special attention must be paid to the frequency of analgesic use, both prescription and over-the-counter, to identify analgesic rebound headache. A thorough neurologic examination must also be performed; if it is normal, there is usually no need for special tests. Headaches are classified as either primary or secondary. Primary headaches have no structural or metabolic cause, while secondary headaches are caused by an underlying pathologic or metabolic process. Migraine, tension-type, cluster, and analgesic-rebound headaches are all primary headache disorders. Secondary headaches are caused by conditions such as increased intracranial pressure, pseudotumor cerebri, subdural and intracerebral hematomas, hypertension, meningitis, temporal arteritis, Lyme disease, and brain tumors. Accurate diagnosis of headache is essential to determine the appropriateness of further testing and to guide proper treatment of the patient's condition.

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Authors+Show Affiliations

Marks DR
New England Center for Headache, Stamford, Connecticut 06902-1249, USA.
Rapoport AM
No affiliation info available

MeSH

AnalgesicsDiagnosis, DifferentialEvaluation Studies as TopicHeadacheHumansMedical History TakingMigraine DisordersPhysical ExaminationTension-Type Headache

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

9474710

Citation

Marks, D R., and A M. Rapoport. "Practical Evaluation and Diagnosis of Headache." Seminars in Neurology, vol. 17, no. 4, 1997, pp. 307-12.
Marks DR, Rapoport AM. Practical evaluation and diagnosis of headache. Semin Neurol. 1997;17(4):307-12.
Marks, D. R., & Rapoport, A. M. (1997). Practical evaluation and diagnosis of headache. Seminars in Neurology, 17(4), 307-12.
Marks DR, Rapoport AM. Practical Evaluation and Diagnosis of Headache. Semin Neurol. 1997;17(4):307-12. PubMed PMID: 9474710.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Practical evaluation and diagnosis of headache. AU - Marks,D R, AU - Rapoport,A M, PY - 1997/1/1/pubmed PY - 1998/2/25/medline PY - 1997/1/1/entrez SP - 307 EP - 12 JF - Seminars in neurology JO - Semin Neurol VL - 17 IS - 4 N2 - Establishing an open and honest physician-patient relationship is essential for the proper evaluation and management of headache disorders. Obtaining a complete headache and medical history is the most important part of the initial diagnostic evaluation. This history should include information about headache onset, pain intensity, character of the pain, presence of aura, associated autonomic symptoms, and trigger factors. Special attention must be paid to the frequency of analgesic use, both prescription and over-the-counter, to identify analgesic rebound headache. A thorough neurologic examination must also be performed; if it is normal, there is usually no need for special tests. Headaches are classified as either primary or secondary. Primary headaches have no structural or metabolic cause, while secondary headaches are caused by an underlying pathologic or metabolic process. Migraine, tension-type, cluster, and analgesic-rebound headaches are all primary headache disorders. Secondary headaches are caused by conditions such as increased intracranial pressure, pseudotumor cerebri, subdural and intracerebral hematomas, hypertension, meningitis, temporal arteritis, Lyme disease, and brain tumors. Accurate diagnosis of headache is essential to determine the appropriateness of further testing and to guide proper treatment of the patient's condition. SN - 0271-8235 UR - https://www.unboundmedicine.com/medline/citation/9474710/Practical_evaluation_and_diagnosis_of_headache_ L2 - http://www.thieme-connect.com/DOI/DOI?10.1055/s-2008-1040943 DB - PRIME DP - Unbound Medicine ER -