Along with back pain, headaches are the most common form of chronic, recurring pain. Although many people think that headaches invariably indicate some severe underlying pathology such as a brain tumor, in fact most headaches are primary ones that have no such identifiable pathology and do not require further workup. Furthermore, the most common type of secondary headaches, medication overuse headaches, result from the treatment of primary headaches. It is also important to note that when severe underlying pathology is present, there are usually “red flags” that indicate the need for further workup.
1. Which of the following are considered “red flags” that indicate the possibility that severe underlying pathology may be the cause of a headache?
A. A change in mental status
B. The worst headache the person has ever experienced
C. Presence of fever
D. First onset of headache after age 50
E. All of the above
2. The most common type of headache is:
A. Tension-type headache
B. Migraine with aura
C. Migraine without aura
D. Cluster headache
3. Based on current research, it is clear that migraine with aura and migraine without aura have similar etiologies and are markedly different from tension-type headaches.
4. The word “tension” in tension-type headache refers to muscle tightness.
5. Which of the following are characteristic of tension-type headache?
B. Usually aggravated by routine physical activity
C. Usually bilateral
D. All of the above
E. A and C
Dr. King is in private practice in New York, and he is Clinical Professor of Psychiatry at the New York University School of Medicine.
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