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3 - Approach to History Taking and the Physical Examination

Published online by Cambridge University Press:  09 October 2017

Serena L. Orr
Children’s Hospital of Eastern Ontario, Ottawa
Benjamin W. Friedman
Albert Einstein College of Medicine, New York
David W. Dodick
Mayo Clinic, Phoenix, AZ
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The majority of patients presenting to the emergency department (ED) have non-life-threatening primary headaches such as migraine, tension-type, or cluster headache. It is important to differentiate this group from the smaller number of patients with a secondary headache disorder, which can be serious with potentially fatal outcomes.

A careful history and physical examination is the most important part of the evaluation of the patient presenting to the ED with headache. This helps to determine whether there is a significant risk for secondary headache and whether additional investigations are needed.

This chapter discusses how to approach adults who present to the ED with headache, with an emphasis on determining elements of the history indicative of an underlying secondary cause as well as important questions to ask patients presenting with a primary headache disorder. In addition, key elements of the general medical and neurological examination will be reviewed.

Emergency Headache
Diagnosis and Management
, pp. 15 - 25
Publisher: Cambridge University Press
Print publication year: 2017

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