The Rational Clinical Examination
David L. Simel, Drummond Rennie
Migraine
David L. Simel
Make the Diagnosis: Does This Patient With Headaches Have a Migraine or Need Neuroimaging?
Topics Discussed:
cluster-type headache, criterion standard comparisons (diagnostic tests), diagnostic imaging, headache, likelihood ratio, make the diagnosis, migraine, neuroimaging, neurologic examination, primary thunderclap headache, reference standards, tension-type headache
Excerpt:
"Headaches are ubiquitous with a lifetime prevalence of >94%.1 When
a patient has headaches frequently, and the headaches are unrelated
to underlying conditions, he or she has a primary headache disorder.
Neuroimaging for primary headache disorders (tension, migraine,
or cluster) rarely reveals important intracranial pathology. Thus,
the physicians must identify patients at risk for serious disorders
to avoid unnecessary studies...."
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