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Headache

  • Common ddx

    • tension headache, migraine, sinusitis, flu, pseudotumor cerebri, TMJ syndrome, nitrate usage, cervical strain, hangover
  • Serious ddx

    • meningitis, encephalitis, RMSF, brain abscess, SAH, brain hematoma, head tumor, NPH, concussion, glaucoma, hypertensive headache, CO exposure
  • Labs

    • CBC
    • head CT if neuro sx or head trauma.
    • LP if suspect meningitis
    • ESR if suspect temporal arteritis
    • flu test if suspected
    • consider MRI
    • angiography if suspect aneurysm
  • Trauma ddx

    • concussion, cerebral contusion, epidural hematoma, subdural hematoma, SAH
  • Infectious ddx

    • meningitis, RMSF, encephalitis, brain abscess, flu, sinusitis
  • Mass effect ddx

    • brain tumor, brain abscess, brain hematoma
  • Drug ddx

    • nitrates, caffeine, EtOH, withdrawals
  • Other ddx

    • cluster headache, trigeminal neuralgia, temporal arteritis, shingles, cervical spondylosis
  • HPI

    • onset
    • location: unilateral vs bilateral, front vs back
    • quality: sharp vs dull, constant vs throbbing
    • quantity
    • aggravation
    • alleviation
  • ROS

    • trauma
    • fever
    • rash
    • photophobia, visual changes, eye pain
    • runny nose, sneezing, congestion, sinus pressure, sore throat
    • stiff neck
    • cardio: chest pain
    • pulm: dyspnea, cough
    • GI: nausea, vomiting, diarrhea
    • neuro: numbness, tingling, incontinence, ataxia
    • MSK: neck-shoulder pain, jaw pain
  • PMH

    • migraines
    • cancers
  • Meds

    • nitrates
  • Allergies

  • FH

    • migraines
  • SH

    • EtOH, tobacco, caffeine
    • illicit drugs
    • occupation, stress, posture, neck strain, new pillow
    • CO exposure
  • Px

    • vitals: HR, BP, SpO2
    • gen impression
    • skin: rash, petechiae
    • head: deformities, wounds, bruising
    • neck: ROM
    • eyes: unequal pupils, papilledema, EOM
    • ENT: sinus tenderness, TMJ, dentition, pharyngitis
    • cardio
    • pulm
    • neuro: grip, strength, reflex, finger-to-nose, gait

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    Disclaimer: MDHero Workups is for educational use only, and is not meant to replace the clinical judgement of a professional. We do not guarantee the accuracy of any information on this website.