TAILIEUCHUNG - Ebook ABC of headache: Part 2

(BQ) Part 2 book “ABC of headache” has contents: Teenage headache, exertional headache, thunderclap headache, headache and brain tumour, headache and neck pain, headache and depression, pain in the temple, facial pain. | CHAPTER 8 Teenage Headache Ishaq Abu-Arafeh OVERVI EW • Headache is common in teenagers • Migraine and tension-type headache are the most common causes • Mixed headaches can confuse diagnosis and treatment Time questions Amy has had headaches for the past three years. She gets one or two type 1 headaches each month. The headache builds up in intensity over a period of 60 minutes and each attack lasts 12–24 hours. Type 2 headaches occur almost every day of the week and each attack lasts 2–3 hours. • Headache diaries are useful in making the diagnosis of different types of headache • Emotional and psychological factors play an important role in daily headaches and should be considered in the assessment and management of teenagers with headache • Headache can have a significant impact on education and family life • Investigations are rarely needed if the history is typical and examination normal • Explanation of the diagnosis and education of the teenager and the family improve compliance with advice and treatment Character questions In type 1 the pain is throbbing in nature with maximum intensity around the forehead and one side of the head. Amy describes type 2 headaches as ‘just sore’ round the head. Cause questions There are no known warning symptoms or trigger factors. • Treatment should be individualized to the headache profile CASE HI STO RY The girl with two different headaches Amy, a 14-year-old, attends the clinic complaining of headache. Amy and her mother are concerned about the headaches as she is losing time from school. Amy lives with her mother and younger sister (11 years). Her parents separated two years ago and she and her sister spend one weekend every fortnight with their father and his partner. Response to headache questions With type 1 headaches Amy is unable to carry out any activities and is forced to lie down. She feels better after rest and sleep. Paracetamol helps a little, but she finds codeine more helpful in relieving .

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