Headaches

What symptoms would you class as RED FLAGS?

• New onset headache over 50years

• Slow onset headache developing over the day

• Headache with photophobia

• Headache with confusion

• Sudden onset headache

A 50 year old Male presents with unbearable pain around the left eye. His left eye is watering, erythema is noted around the eye and his pupil is dilated. He appears somewhat agitated. What is the most LIKELY diagnosis?

• Migraine

• Cluster headache

• Sinusitis

• Subarachnoid Haemorrhage

• Trigeminal Neuralgia

What is the most effective way to prevent migraine and tension headaches?

A patient presents with a generalised headache which has been developing over the last 24 hours, they feel nauseous but have not vomited. They ask you to turn the lights off in the examination room during the consultation. On examination they have a temperature of 39 degrees Centigrade, they are not able to put their chin to their chest and they do not have a rash. What diagnosis is at the top of your differentials?

• Subarachnoid Haemorrhage

• Meningitis

• Sinusitis

• Temporal Arteritis (GCA)

• Migraine with aura

How can we help patients establish the triggers for their headaches?

A 70 year old female has a telephone consultation with her GP. She reports a constant, throbbing, mild headache on the right side of the head for the last week. She reports it is worse on chewing and on brushing her hair. She has no visual changes, no nausea or vomiting and no rash. The GP believes she may have Temporal Arteritis. What positive findings from the patients history help the GP to reach this conclusion?

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