headache

DC Inst – Headache

DC

You have been evaluated in the Emergency Department today for headache. Your evaluation did not show evidence of medical conditions requiring emergent intervention at this time, and your pain improved with medication in the ED.

We recommend you take 600mg ibuprofen every 6 hours or tylenol 650mg every 6 hours as needed for pain. If needed, you can alternate these medications so that you take one medication every 3 hours. For instance, at noon take ibuprofen, then at 3pm take tylenol, then at 6pm take ibuprofen.

Please follow up with your primary care physician within two days.

Return to the Emergency Department if you experience worsening or uncontrolled pain, vision changes, recurrent vomiting, difficulty with normal activities, abnormal behavior, difficulty walking, numbness, weakness, or any other concerning symptoms.

Thank you for choosing us for your care.

HEADACHE – Low Risk, Pregnancy

MDM

This patient presents with a headache most consistent with ***. Differential diagnosis includes migraine versus tension type headache. No headache red flags. Neurologic exam without evidence of meningismus, focal neurologic findings. Presentation not consistent with acute intracranial bleed to include SAH (lack of risk factors, headache history). Presentation not consistent with acute CNS infection to include meningitis or brain abscess, Temporal arteritis unlikely, as is acute angle closure glaucoma given history and physical findings. Presentation not consistent with other acute, emergent causes of headache at this time. Plan to treat symptomatically with pain medication. No indication for imaging/LP at this time.***

Plan: pain medication, CT brain***, serial reassessment

HEADACHE IN PREGNANCY

This pregnant patient presents with headache of rapid onset. Etiology is unclear but includes possible preeclampsia, HELLP, SAH or other ICH. Considered, but think unlikely, CVT, Waterman’s syndrome, carotid dissection. Plan to work up with basic labs, UA to screen for proteinuria, consider head CT, pain control, reassess.