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Headache (Secondary (Cranial (Stroke/cerebral venous thrombosis,…
Headache
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Primary
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Cluster (urgent referral)
- intense pain
- watery eyes/watery nose
- injected conjunctivitis
acute (analgesia, TCA), prevention (verapamil), bridging (steroids)
Migraine (POUND x 5, photophobia/phonophobia, aura)
- occasional pulsatile, keep still, can be bilateral with occasional unilateral
- 2 out of 4 PUMA
- check for trigger/lifestyle, acute tx, preventive measures
ABCDE (topimax for obesity), riboflavin for pregnancy (urine yellow)
- do not use tramadol (got better agents)
- can have some dizzyness
Idiopathic stabbing headache
- similar to migraine but very transient/short live
- mx: gabapentin/pregab
S(initial+now)OOCRATES + nocturnal awakening
- meningitis: fever, neck stiffness, photophobia, rash
- stroke/ICH: neuro deficits, dysphagia
- tumour: BOV/eye pain/migraine aura, N/V, LOA/LOW