Medical Assessment for Headaches: Outlining the Process
In the quest to understand and address headaches, doctors employ a thorough approach that combines questioning and physical examination. This process helps differentiate between benign and potentially dangerous causes, identify neurological deficits, and plan effective management strategies.
During a physical exam for headaches, doctors ask questions about various aspects of the headache, such as its frequency, intensity, location, duration, and associated symptoms. These questions help determine the type of headache and whether it might be indicative of a more serious condition like a brain tumor, stroke, or inflammation.
Specifically, doctors inquire about headache characteristics, associated symptoms, triggers and history, impact on daily life, and potential food triggers or medication use. They also assess a person's vital signs, blood pressure, reflexes, and temperature.
A neurological examination is also an integral part of the process, assessing mental status, cranial nerves, motor strength, reflexes, sensory function, coordination, gait, and balance. This comprehensive evaluation helps identify signs of neurological disorders.
If doctors suspect that a person's headaches are because of an underlying condition, they may recommend additional tests such as blood and urine tests, neurological exams, MRIs, or CT scans to check for brain tumors, hemorrhages, inflammation, seizures, or infections.
Common types of headaches include tension headaches, migraines, and cluster headaches. These headaches do not indicate an underlying condition and are called primary headaches. However, doctors can usually diagnose these during a physical exam.
In addition to the physical examination, doctors take a detailed look at a person's medical history and lifestyle. They consider factors such as changes in sleeping habits, sensations of nausea, vomiting, or dizziness, whether or not the person has performed strenuous exercise, potential food triggers, and alcohol or caffeine consumption.
Doctors also examine the eyes to check for changes in a person's visual field, the size of the pupil, and the eyes' tear production and response to light. They check for tenderness or swelling of the scalp, temporal artery, joints that connect the lower part of the jaw to the skull, and the middle part of the throat behind the mouth. They examine the cervical spine for tenderness and check for tooth pain and examine the neck to identify stiffness or discomfort, as this could indicate meningitis.
The NINDS recommends keeping a headache diary to help explain symptoms and highlight any possible patterns or behaviors that lead to headaches. A person must contact a doctor if they have a sudden headache with a stiff neck, headaches that worsen as days pass, any traumatic head injuries, a headache and loss of feeling in any part of the body, convulsions, any headaches that leave the person confused or experiencing double vision, a headache that changes with position, or a change in the pattern of headaches they typically experience.
In summary, a physical exam for headaches is a crucial step in determining the cause of a person's headaches and planning appropriate treatment. By asking a series of questions and performing a comprehensive neurological examination, doctors can identify potential underlying conditions and develop effective management strategies.
In the course of a headache diagnosis, doctors may uncover indications of additional medical-conditions, such as migraines, further emphasizing the importance of a thorough health-and-wellness examination. This approach to headache management also extends to mental-health considerations, as some headaches may originate from anxiety, stress, or other psychological factors.
