The management of the patient with headache: from evidence to clinical practice

Abstract

EpidemiologyHeadaches are the most prevalent neurological disorders and are among the most frequent symptoms seen in general practice. The headache is about 30% of neurological specialist visits and continues to be a frequent cause of ED use, accounting for 2% of all visits. 4 50% of the general population have headaches during any given year, and more than 90% of them report a lifetime history of headache. 5 The only Italian epidemiological study (PACE study) 6 showed that 52% of men a and 43% of women interviewed suffered from headache in the last year. 7 Primary headache Migraine IntroductionMigraine is a common, debilitating headache disor- ABSTRACTHeadaches are the most prevalent neurological disorders and continue to be a frequent cause of Emergency Department use, accounting for 2% of all visits. Although it is a neurological disease it must be also a clinical competence of internist for its nature and frequency. The keys to effective management of these syndromes are differential diagnosis through history, physical examination, and diagnostic studies when necessary. This monograph highlights the importance of establishing whether headache is a secondary symptom of another disease process or a primary condition. The goal of headache management is for patients and healthcare professionals to work together to minimize pain and improve quality of life.

Approach to a patient with a headache in the general practice setting

“…Although primary headaches are the most common, one of the biggest challenges is diagnosing secondary headaches. 11 Analyzing correct answers for the different types of headaches we found a surprisingly low percentage of GPs (56.9%) who gave correct answers to questions about the headaches due to cranial or cervical vascular events. Although these are the most common secondary headaches in general practice.…”

“…Iako su primarne glavobolje najčešće, jedan od najvećih izazova u domenu glavobolja je identifikacija sekundarnih glavobolja 11 .…”

The physiology of orgasmic headache

“…Headache is the most common neurological condition and continues to be a prominent cause of emergency department use. 6,7 It is a painful disorder of the head that is occasionally combined with discomfort in the face and/or neck. It is a nearly universal human experience and one of the most commonly reported symptoms in medicine and neurology.…”