- Perform a patient-centered interview that identifies:
- Symptoms of secondary headaches, including red flags of potentially serious causes (e.g. intracranial bleed, meningitis etc.).
- Features that may differentiate types of headache that commonly present in primary care e.g. migraine, tension, sinus, and medication over-use headaches.
- Perform a focused physical exam that identifies signs of secondary causes, including potentially serious causes.
- Use diagnostic criteria to diagnose a patient with migraine.
- Propose a management plan that includes:
- Appropriate and timely investigation & disposition if a potentially serious secondary cause is suspected.
- Appropriate evidence-informed pharmacological and non-pharmacological modalities for common headache types (ie migraine, tension).
- Response to patient fears and expectations providing reassurance when appropriate.
Headache Clinical Card
Creba AS, Walker I, Keegan DA. Headache. Canadian Family Medicine Clinical Card. 2011. Available at: https://sites.google.com/site/sharcfm/
Approach to the Undifferentiated-Headache
Wong D, Thomas M. Undifferentiated Headache One-Page Primer. DFCM Open. 2013. Available at: http://dfcmopen.com. Attribution CC BY-NC-ND
Wong D, Hooks R. Migraine Tension Headache One-Page Primer. DFCM Open. 2013. Available at: http://dfcmopen.com. Attribution CC BY-NC-ND
Guideline for primary care management of headache in adults
Becker WJ, Findlay T, Moga C, Scott NA, Harstall C, Taenzer P. Guideline for primary care management of headache in adults. Can Fam Physician. 2015;61(8):670-679. doi: 61/8/670 [pii].
CORE Neck Tool and Headache Navigator
Toronto: Centre for Effective Practice. Reprinted with Permission from Centre for Effective Practice (July 2016). CORE Neck Tool and Headache Navigator. https://thewellhealth.ca/wp-content/uploads/2016/07/CEP_HeadandNeck_2016_v15.2-1.pdf
Office Emergencies emodule
Jansz G, Law M, Lee S et al. Office Emergencies: Family and Community Medicine Clerkship Core Curriculum Module. University of Toronto.