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  • HeadacheAlgorithm2 5.pdf1

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    Primary headache is likely No Two of the following are present?: - pulsating, moderate - severe intensity, aggravated by routine activities Rule out secondary causes of headache Proceed to management protocols. Headache of recent origin ( 6 months) 2. A recent increase in the frequency and / or severity of the headache experience 3. Presence of CNS and/ or cranial nerve abnormalities 4. Trauma Yes No Recurrent, unilateral severe headache of short duration Yes Cluster headache.

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    Primary headache is likely No Two of the following are present?: - pulsating, moderate - severe intensity, aggravated by routine activities Rule out secondary causes of headache Proceed to management protocols. Headache of recent origin ( 6 months) 2. A recent increase in the frequency and / or severity of the headache experience 3. Presence of CNS and/ or cranial nerve abnormalities 4. Trauma Yes No Recurrent, unilateral severe headache of short duration Yes Cluster headache.

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    Attribution Non-Commercial (BY-NC)
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    52 vizualizări3 pagini

    HeadacheAlgorithm2 5.pdf1

    Încărcat de

    adnajani
    Primary headache is likely No Two of the following are present?: - pulsating, moderate - severe intensity, aggravated by routine activities Rule out secondary causes of headache Proceed to management protocols. Headache of recent origin ( 6 months) 2. A recent increase in the frequency and / or severity of the headache experience 3. Presence of CNS and/ or cranial nerve abnormalities 4. Trauma Yes No Recurrent, unilateral severe headache of short duration Yes Cluster headache.

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    din 3

    Chapter 2 Diagnostic Algorithms

    5 Headache Algorithm

    Date revised 12/23/03

    Headache Algorithm

    Patient with complaint of headache

    Primary Headache Algorithm (Submitted by Levittown Health Center Headache Working Group)

    Presence of headache red flags (A)

    No

    Primary headache is likely

    Yes Two of the following are present?: - pulsating, moderate - severe intensity, aggravated by routine activities Rule out secondary causes of headache Proceed to Algorithm 2 No No Migraine without aura. Proceed to management protocols

    Yes

    No

    One of the following is present?: - nausea, vomiting - photo/phono phobia

    Yes

    Are prodomal symptoms present?

    Yes Pressing, tightening non-pulsating, mild or moderate, bilateral, not aggravated by physical activity?

    Migraine with aura. Proceed to management protocols

    Yes No > 15 attacks per month for at least 6 months, and nausea, or photo or phono phobia Yes Chronic tension headache. Proceed to management protocols Episodic tension headache. Proceed to management protocols

    No

    Historical / Examination Red Flags (A) Posterior headache with possible anterior projection and neck pain, aggravated by neck motions or sustained neck posture and physical and radiographic evidence of cervical spine involvement? Cervicogenic headache. Proceed to management protocols

    1. Headache of recent origin (< 6 months) 2. A recent increase in the frequency and/or severity of the headache experience 3. Presence of CNS and/or cranial nerve abnormalities 4. Trauma

    Yes

    No

    Recurrent, unilateral severe headache of short duration

    Yes

    Cluster headache. Proceed to management protocols

    Educational and Patient Care Protocols Chapter 2 - 5

    Date revised 12/23/03

    Headache Algorithm Page 2


    Secondary Headache Algorithm
    Possible secondary headache

    Yes

    Meningitis. Immediate referral to Emergency Department

    Nuchal rigidity

    Yes

    Fever Subarachnoid hemorrhage. Immediate referral to Emergency Department

    No No

    Temporal artery tender, thickened, granular quality, elevated ESR

    Yes

    Temporal arteritis. Refer to primary care physician for management

    No

    Blurred vision and pain around eye?

    Yes

    Acute glaucoma. Refer for ophthalmic consultation

    No Tumor. Refer for neurologic consultation

    No CN and/or CNS (including mental status) abnormalities

    Yes

    History of head trauma

    Yes

    No

    Elderly patient (trauma may be trivial or not recalled)

    Yes

    Chronic subdural hematoma. Refer for neurologic consultation

    Atypical primary headache. Proceed to management protocol Post-traumatic syndrome (includes tension-type and migraine presentations) Return to primary HA algorithm

    No

    Educational and Patient Care Protocols Chapter 2 - 5

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