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This volume is designed to accomplish 3 specific tasks. First, to help the clinician quickly and accurately identify those patients, based on a brief history and examination, who require investigations to rule out a specific secondary cause for headache. The clinical evaluation should therefore generate a short differential diagnosis and guide the selection of appropriate investigations. The most important secondary causes, especially those that are commonly overlooked, will be briefly discussed, primarily setting out how each disorder presents and when to be suspicious, which tests are appropriate, and the definitive treatment. Second, for those patients with a recurrent primary headache disorder that has not responded to self-administered therapies, an evidence-based approach with specific medication algorithms will be provided. Finally, since 50% of emergency department visits for headache are generated by 'repeat' patients, or so-called frequent fliers, a practical approach to improving outcomes for and reducing repeat visits by these patients will be offered.
David Dodick, Mayo Clinic, Scottsdale, AZ, USA
Table of Contents
I. Diagnostic Evaluation.1. Epidemiology.2. Focused history and examination.3. The role of imaging and laboratory evaluation.II. Sinister secondary headaches: How they present and how not to miss them.1. Subarachnoid hemorrhage.2. Arterial dissection.3. Cerebral Venous sinus thrombosis.4. Reversible cerebral vasoconstriction syndrome.5. Spontaneous intracranial hypotension.6. Intracranial infections: Meningitis / encephalitis / sinusits.7. Idiopathic intracranial hypertension (Pseudotumor cerebri).8. Giant cell arteritis.9. Intracranial neoplasm.10. Ischemic and hemorrhagic stroke.III. Intractable primary headaches: how to manage them.1. Migraine.2. Cluster headache.3. Medication overuse headache (rebound).4. Trigeminal neuralgia.5. Primary exertional headache.6. Primary sexual headache.IV. The 'frequent fliers' and 'drug-seeking patients'; how to effective manage these patients