Headache diagnosis

Ruoff G, Urban G. Treatment of primary headache episodic tension-type headache. In Standards of care for headache diagnosis and treatment. Chicago National Headache Foundation, 2004 53-58. 

HaUcer R, Vargas B, Dodick DW (2010) Clustea- Headache Diagnosis and Treatment. Semin Neurol 30 175... 

What characteristics of the headache support this diagnosis ... 

Clinical Presentation and Diagnosis of Tension-Type Headache ... 

Silberstein SD, Lipton RB, Dalessio DJ. Overview, diagnosis, and classification of headache. In Silberstein SD, Lipton RB, Dalessio DJ, eds. Wolff s Headache and Other Head Pain. 7th ed. New York Oxford University Press, 2001 6-26. 

CDC Case Definition An illness characterized by acute or insidious onset of fever, night sweats, undue fatigue, anorexia, weight loss, headache, and arthralgia. Laboratory criteria for diagnosis is (1) isolation of Brucella species from a clinical specimen or (2) fourfold or greater rise in Brucella agglutination titer between acute- and convalescent-phase serum specimens obtained >2 weeks apart and studied at the same laboratory or (3) demonstration by immunofluorescence of Brucella species in a clinical specimen. 

Signs and Symptoms Diagnosis of psittacosis can be difficult. There is a variable clinical presentation but may include fever, headache, muscle pain (myalgia), chills and upper or lower respiratory tract disease, and dry cough. Pneumonia is often evident in chest x-rays. 

CDC Case Definition An illness caused by S. typhi that is often characterized by insidious onset of sustained fever, headache, malaise, anorexia, relative bradycardia, constipation or diarrhea, and nonproductive cough. However, many mild and atypical infections occur. Carriage of S. typhi may be prolonged. Laboratory criteria for diagnosis is isolation of S. typhi from blood, stool, or other clinical specimen. 

Diagnosis of a urea cycle defect in the older child can be elusive. Patients may present with psychomotor retardation, growth failure, vomiting, behavioral abnormalities, perceptual difficulties, recurrent cerebellar ataxia and headache. It is therefore essential to monitor the blood ammonia in any patient with unexplained neurological symptoms, but hyperammonemia is inconstant with partial enzymatic defects. Measurement of blood amino acids and urinary orotic acid is indicated. 

Fever and a history of headaches are the most common symptoms of cryptococcal meningitis, although altered mentation and evidence of focal neurologic deficits may be present. Diagnosis is based on the presence of a positive CSF, blood, sputum, or urine culture for Cryptococcus neoformans. 

A comprehensive headache history is the most important element in establishing the diagnosis of migraine. 

Let us assume that Mr. Z does indeed have leukemia. For many conditions claimed by plaintiffs, especially those that are highly subjective in nature (headaches, nausea, intermittent skin rashes, insomnia, muscle pain), a similarly objective diagnosis may not be possible this creates many problems in causation evaluation which we shall not try to cope with here. But to evaluate the likelihood that Mr. Z s leukemia was caused by one or more water contaminants, it will be necessary to determine whether there is evidence in the scientific literature that is sufficient to establish a causal link (in the sense, for example, described by lARC and discussed in Chapter 6) between exposure to any one of those contaminants and leukemia. This evaluation is referred to as an analysis of general causation. Thus, it is directed at the question of whether one or more of the chemicals to which Mr. Z was exposed is known, in a general sense, to be a cause of leukemia. If benzene is, for example, one of the chemicals found in Mr. Z s well, and it can be established that he consumed water containing benzene, then we could conclude that general causation is established. 

A truck spill in 1985 resulted in exposure of an estimated 80 people. Signs and symptoms were headache in six persons, mucous membrane irritation in five, dizziness in five, and chest discomfort in four. Eleven of 41 persons tested had slightly elevated SCOT and/or SGPT values. In 28 persons interviewed 12 weeks after exposure, complaints were headache in 12, abdominal discomfort in 6, chest discomfort in 5, and malaise in 5. In one case the diagnosis was pneumonia, based on persistent dyspnea and cough. 

Danazol has been associated with several cases of benign intracranial hypertension also known as pseudotumor cerebri. Early signs and symptoms of benign intracranial hypertension include papilledema, headache, nausea, and vomiting, and visual disturbances. Screen patients with these symptoms for papilledema and, if present, advise the patients to discontinue danazol immediately and refer them to a neurologist for further diagnosis and care. 

---