Headaches Video

Steve B

The hour long video we watched was about headaches and the many presentations headaches and migraines can show up in our office. We can have classic migraines, common migraines, tension headaches, cervicogenic headaches, cluster headaches, and hypertensive headaches. Migraines can often be missed diagnosed as sinus tension headaches and to help differentiate the two it is important to take a detailed history on the patient. A one-year Denmark study found that the most common type of headache that patient presented with was tension type headaches. The classic presentation would be pressure or pain in a hatband distribution on the patient’s head. Migraine headaches were only 10% of presentations and the least common was cluster headaches, which were only 0.14% prevalent.

A migraine is a headache that lasts from 4-72 hours and untreated and must have two of the following: unilateral location; pulsating quality; moderate or severe intensity; aggravation by routine and physical activities. Patient must also have one of the following: nausea; vomiting; or photophobia. Episodic migraines patients must have less than 15 per month over the past three months. Chronic migraines must present with greater than 15 headaches over a three-month period and at least eight of the headaches must meet criteria for migraine without aura. Cannot be because of mediation overdose or side effect. Migraine transformation occurs in 2-3% of patients annually and it is when an epidotic migraine transforms into a chronic headache. Migraine can be with or without aura with 5% of the population having both presentations. If a patient presents with a migraine with aura you need to rule out possible stroke and aura may handicap patient’s vision. Aura most commonly starts in the fingers and moves up the arm. A stroke presentation will have the entire arm involved. Ninety three percent of the time the aura is experienced on its own before the headache; where as 3% of the population will...