A 42-year-old married woman with 2 school-age children consults her family physician for a severe headache of about 7 days' evolution. Although she has been having similar episodes for more than a year, in the last 2 months they have worsened considerably. The pain is like a weight that starts in the occipital area, spreads to both temporal regions and is barely relieved by taking 650 mg paracetamol tablets, so she requests a CT scan (she is convinced that "something must be wrong with her head"). Which of the following is the most plausible cause of her headache?
Just as last year they wanted to paint a nurse as bad for waking us up for a patient with myasthenia, this year they entertain us by presenting a patient asking for a CT scan. I interpret that they show a patient stressed by her children with recurrent headaches of occipital location that she previously relieved with a low dose of paracetamol and now she does not. Both the initially occipital location, the 2-year evolution time, and the sensation of weight lead to answer 4, a tension headache. Migraine and vascular disorders, accompanied by other neurological symptoms or nausea, photophobia, etc., are quickly ruled out, as well as the rare temporal arteritis before the age of 50 years. Tumor headache is usually "in crescendo", not recurrent as the case suggests, and is accompanied by other neurological symptoms or intracranial hypertension.
Migraine.
Vascular disorders.
Temporal artery arteritis.
Tension.
Oncologic.
Migraine and vascular disorders, accompanied by other neurological symptoms or nausea, photophobia, etc., are quickly ruled out, as well as the rare temporal arteritis before the age of 50 years.
Migraine and vascular disorders, accompanied by other neurological symptoms or nausea, photophobia, etc., are quickly ruled out, as well as the rare temporal arteritis before the age of 50 years.
Migraine and vascular disorders, accompanied by other neurological symptoms or nausea, photophobia, etc., are quickly ruled out, as well as the rare temporal arteritis before the age of 50 years.
Both the initially occipital location, the 2-year evolution time, and the sensation of weight lead to answer 4, a tension headache.
Tumor headache is usually "in crescendo", not recurrent as the case suggests, and is accompanied by other neurological symptoms or intracranial hypertension.