The Role of Laboratory Testing in the Evaluation of Headache

Donohoe, Charles D.

doi:10.1016/j.mcna.2012.12.002

Cited by 4 publications

(5 citation statements)

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“…Some studies indicate that thyroid issues are common in chronic daily headaches, so screening may be needed [ 10 , 11 ]. However, a different study found that ordering thyroid function tests has only a small impact on managing headaches [ 12 ]. Another study contradicts this idea [ 13 ].…”

Section: Discussionmentioning

confidence: 99%

Bilateral Temporal Headache As the Presenting Symptoms for a Case of Graves’ Disease

Alsabban,

Bakri,

Abduljabbar

et al. 2023

Cureus

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Headache is not typically a presenting symptom of Graves' disease. Only a few studies suggest hyperthyroidism can cause headaches, and the connection remains indeterminable. While some cases report hyperthyroidism presenting as a simple headache, it is not specific to Graves' disease. This report details a middle-aged male patient who visited a primary healthcare center with a two-month history of bilateral temporal headaches. He was initially diagnosed as a query case of temporal arteritis due to his age and affected area and was transferred to the emergency department for a comprehensive evaluation. After discussions with specialists and various laboratory tests and CT scans, he was diagnosed with Graves' disease. Treatment led to fast improvement and relief of his headaches. This case represents a rare instance of Graves' disease where the patient's sole complaint was a simple headache without any other symptoms. We advise doctors to consider diseases related to increased thyroid gland activity when dealing with headaches.

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Section: Discussionmentioning

confidence: 99%

Bilateral Temporal Headache As the Presenting Symptoms for a Case of Graves’ Disease

Alsabban,

Bakri,

Abduljabbar

et al. 2023

Cureus

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“…MRI scanning of the cervical spine should also be obtained in those patients whose headache symptoms have a significant occipital or nuchal component [7,8,27]. Laboratory testing including a complete blood count, erythrocyte sedimentation rate, and automated blood chemistry should be obtained when the diagnosis of migraine headache is in question or if the patient is not getting better [6,8]. Ophthalmologic evaluation, including measurement of intraocular pressures, is indicated in all patients who experience significant ocular symptoms [29].…”

Section: Testingmentioning

confidence: 99%

“…Headache triggers are ignored (especially caffeine, wine and HRT) 5. Medication misadventures (including too much too early, too little too late, wrong drug due to wrong diagnosis, abortive rather than preventative, drugs prone to cause rebound headache, and of course non-compliance) 6. Failure to identify co-morbid conditions (the magnetic resonance imaging (MRI) was normal, but I didn't take a blood pressure) 7.…”

Section: Introductionmentioning

confidence: 99%

“…If you keep your index of suspicion high enough and then simply pay attention to the patient, you will almost always know when the patient is really sick and that it is time to pull out all the stops. Good clinicians know "sick from well" and if your gut tells you that something is really wrong, rethink the situation, get help, and most importantly, do not hang your hat on previously normal laboratory tests and neuroimaging [6]. Repeat everything and above all, carefully re-examine the patient.…”

Section: Introductionmentioning

confidence: 99%

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Diagnosis and Treatment of Common Headache Syndromes: A Guide for the Clinician

Waldman¹

2014

J Yoga Phys Ther

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Citation: Waldman SD, Waldman CW, Waldman RA (2014) Diagnosis and Treatment of Common Headache Syndromes: A Guide for the Clinician. J Yoga Phys Ther 4: 156. Practice Points• The targeted headache history will allow the clinician to correctly diagnose the type of headache the patient is suffering from in the vast majority of cases.• Correct diagnosis is essential if the clinician is going to construct a rational and effective plan of treatment.• Tension-type headache is the most common type of headache encountered in clinical practice.• Migraine headache is associated with significant morbidity.• Aura is a painless neurological dysfunction that precedes the onset of headache pain in patients suffering from migraine with aura.• Cluster headache occurs predominately in males.• Cluster headache follows a unique chronobiological pattern.• Patients suffering from cluster headache frequently exhibit trigeminal autonomic symptoms during acute attacks.• Medication overuse headache is frequently triggered by the overuse of simple analgesics, nonsteroidal anti-inflammatory agents, opioids, caffeine, ergotamines, and triptans. AbstractHeadache is a one of the most common problems encountered in clinical practice. Over 90 per cent of headaches fall into one of four diagnostic categories: (1) Tension-type headache; (2) Migraine headache; (3) Cluster headache; and (4) Medication overuse headache. The mainstay of diagnosis of these common headaches is the taking of a careful targeted headache history. The physical examination in patients suffering from these common headaches is almost always normal and abnormalities identified on physical examination in this patient population should raise concern. Appropriate use of diagnostic imaging including magnetic resonance imaging of the brain and cervical spine is indicated in those patients with a recent onset of headaches and in those patients in whom a previously stable headache pattern has changed. Laboratory testing will also help the clinician rule out co-existent or occult disease that may be contributing to the patient's headache symptomatology. In most cases, treatment plans should be aimed at preventing headache rather than aborting the headache after symptoms have already occurred. Care must be taken to identify overuse or misuse of medications prescribed to treat headache, as many of these medications have the propensity to cause medication overuse headaches.

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“…Although primary headache disorders make up the majority of headaches presenting to clinicians, it can be difficult to effectively identify a primary headache disorder from a secondary headache disorder without the presence of Bred flags^in the history or an abnormal neurologic exam. Examples of red flags are as follows [9][10][11][12][13][14][15][16][17][18][19] Although imaging studies can cause harm by exposing patients to potentially harmful radiation and increasing the cost of care, they can also exclude or identify high-risk pathology and help alleviate patient anxiety. From a research standpoint, emerging techniques such as functional magnetic resonance imaging (MRI), positron emission tomography (PET) scans, and voxel-based morphometry (VBM) can help us understand the pathophysiology behind certain headache disorders.…”

Section: Introductionmentioning

confidence: 99%

Appropriate Use of Neuroimaging in Headache

Kuruvilla

Lipton

2015

Curr Pain Headache Rep

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Headache may be caused by primary disorders, such as migraines, or secondary disorders, such as intracranial neoplasm or hemorrhage. Imaging plays an important role in differentiating between primary and secondary headache disorders. This article reviews the effectiveness of computed tomography (CT) and magnetic resonance imaging (MRI) in the evaluation of a patient with a headache. It also discusses the utility and cost-effectiveness of performing imaging studies in patients with a headache and a normal neurological exam. Emerging imaging techniques such as functional MRI, positron emission tomography (PET) scans, and voxel-based morphometry (VBM) are also discussed.

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The Role of Laboratory Testing in the Evaluation of Headache

Cited by 4 publications

References 0 publications

Bilateral Temporal Headache As the Presenting Symptoms for a Case of Graves’ Disease

Bilateral Temporal Headache As the Presenting Symptoms for a Case of Graves’ Disease

Diagnosis and Treatment of Common Headache Syndromes: A Guide for the Clinician

Appropriate Use of Neuroimaging in Headache

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