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Headache Objectives and References

Objectives:


By the end of Family Medicine Clerkship, students will be able to:


1. Perform a patient-centered interview that identifies:

            a.  Symptoms of secondary headaches, including red flags of potentially serious causes: e.g. intracranial bleed, meningitis, etc.

b. Features that may differentiate types of headache that commonly presents in primary care e.g. migraine, tension, cervicogenic, and medication over-use headaches.

2. Perform a focused physical exam that identifies signs of secondary causes, including potentially serious causes.

3. Use diagnostic criteria to diagnose a patient with migraine.

4. Propose a management plan that includes:

a. Appropriate and timely investigation & disposition if a potentially serious secondary cause is suspected.

b. Includes appropriate evidence-informed pharmacological and non-pharmacological modalities.

c. Response to patient fears and expectations providing reassurance when appropriate


References:


Recommended Resources Addressing the Objectives

Evaluation of acute headaches in adults (8 pages)

Objectives covered: 1ab, 2, 3, 4a

http://www.aafp.org/afp/2001/0215/p685.pdf

Clinch CR. Evaluation of acute headaches in adults. Am Fam Physician 2001 Feb 15;63(4):685-692.

PMID:11237083

Breaking the cycle of medication overuse headache (7 pages)

Objectives covered: 1b, 4bc

http://www.ccjm.org/content/77/4/236.full.pdf+html

Tepper SJ, Tepper DE. Breaking the cycle of medication overuse headache. Cleve Clin J Med 2010 Apr;77(4):236-242.

PMID:20360117

TOP Guidelines for Primary Care Management of Headache in Adults (2 pages)

Objectives covered: 4bc

http://www.topalbertadoctors.org/download/600/Quick%20Reference.pdf

Towards Optimized Practice (TOP). Guideline for Primary Care Management of Headache in Adults. 2012; Available at: 

        http://www.topalbertadoctors.org/download/600/Quick%20Reference.pdf. Accessed July/15, 2014.

        No PMID

Foundational knowledge

The Calgary Guide - Pathophysiology behind why headaches occur:

        http://calgaryguide.ucalgary.ca/slide.aspx?slide=Pain%20Pathways%20in%20the%20Head.jpg

Additional resources

Top 10 causes of headache in family medicine, plus clinical pearls  (1 page):

Objectives covered: 1a, 4c

http://www.ncbi.nlm.nih.gov/pubmed/17934037

Ponka D, Kirlew M. Top 10 differential diagnoses in family medicine: Headache. Can Fam Physician 2007 Oct;53(10):1733.

PMID:17934037



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