Case and Discussion: Headache

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Introduction: In this case, a 35-year-old woman is experiencing bad headaches which have worsened over the past 6 months. As a medical professional, it is important to gather more information about the headache in order to make an accurate diagnosis. Furthermore, it is also important to classify the headache and distinguish between benign and serious ones. This assignment will discuss additional questions to ask, headache classification, determining old vs new and chronic vs episodic headaches, definite diagnosis via open-ended history and focused questions, distinguishing between benign and serious headache conditions, creating a differential diagnosis flow sheet, and including diagnostic tests to assist with diagnosis.

1. What additional questions would you ask to learn more about her headaches?
In order to gather more information about the woman’s headaches, additional questions to ask could include:
– When do the headaches occur?
– Is there a specific trigger for the headaches?
– What kind of pain is experienced during the headache?
– How long do the headaches usually last?
– Have any medications or other treatments been attempted to alleviate the headache?
– Are there any other accompanying symptoms during the headache?

2. How do you classify headaches?
Headaches are classified into different types, including primary and secondary headaches. Primary headaches are not associated with any underlying medical condition, while secondary headaches are caused by underlying medical conditions such as infection or injury. Primary headaches can be further classified into migraine, tension-type, and cluster headaches.

3. How can you determine if this is an old headache or a new headache/s? Is this a chronic or episodic condition?
To determine if the headache is old or new and if it’s a chronic or episodic condition, it is important to ask about the history and frequency of the headaches. Episodic headaches occur less than 15 days per month, while chronic headaches occur more than 15 days per month. Furthermore, an old headache may have different triggers or symptoms than a new headache.

4. Can you make a definite diagnosis through an open-ended history followed by focused questions?
While an open-ended history followed by focused questions can assist in making a diagnosis, it may not provide a definite diagnosis. Additional diagnostic testing may be required to confirm a diagnosis.

5. How can you use the patient history to distinguish between benign headaches and serious ones that require urgent attention?
A patient history can be used to identify any red flags that may indicate a serious headache condition requiring urgent attention. Some red flags include severe pain, sudden onset headache, headache associated with neurological symptoms, or headache in a patient with a history of cancer or HIV.

6. What diagnostic tests do you want to include to help you with your diagnosis?
Diagnostic tests that may assist in diagnosis include imaging tests such as a CT scan or MRI, a lumbar puncture, and blood tests to rule out any underlying medical conditions.

APA References:
American Headache Society. (2018). The International Classification of Headache Disorders, 3rd edition. Cephalalgia, 38(1), 1-211. doi: 10.1177/0333102417738202
Headache Classification Committee of the International Headache Society. (2013). The International Classification of Headache Disorders, 2nd edition. Cephalalgia, 33(9), 629-808. doi: 10.1177/0333102413485658
Mayo Clinic Staff. (2020, November 6). Headache. Retrieved from https://www.mayoclinic.org/symptoms/headache/basics/definition/sym-20050800