[Solved] A 35-year-old Woman Chronic Headache Case Study


Headache: Process and Diagnostics Your objective is to determine a diagnostic workup based on the differential diagnosis for clients presenting with an episodic illness in the care setting. Headache is an exceedingly common symptom in primary care and other practice settings, ranking among the top 10 most frequent symptoms that prompt an office visit. Diagnosis […]

Headaches: Process and Diagnostics

Some additional questions that I would ask the patient to understand her condition better include further explanation of any specific factors that trigger the pain and a description of whether other people in her family have been affected by severe headaches. I would classify the condition as a primary or secondary headache based on the severity of symptoms, frequency of occurrence, and the patient’s medical history. Such information would help determine whether the patient is suffering from a sinus, tension, cluster, or migraine. To determine whether the condition is an old or a new headache, I would assess the frequency of its occurrence within the past month. While episodic headaches cause 10 to 15 attacks in a month for three months, chronic migraine victims experience severe pain for more than 15 days in a month (Young et al., 2019, p. 1042). Through an open-ended history followed by focused questions, I would establish potential risk factors that cause the headache and make an informed intervention that seeks to address the underlying risks that cause the problem.

To determine whether the headache is benign or a serious case requiring urgent attention, I would assess the patient’s medical history and identify any potential factors that could have caused lasting health implications. Such information would present insight into past occurrences that could have caused nonprimary chronic daily headaches, such as inflammation of the blood vessels in and around the brain (Peres et al., 2019, p. 5). Past experiences with infections, such as meningitis, could also inform intervention strategies. Diagnostic tests could include a computed tomography scan to detect infections and injuries and a magnetic resonance imaging test to present detailed pictures of the patient’s brain and surrounding tissues (Evans, 2019, p. 707). I would refer the patient to a neurologist who would provide more specialized care and treat any issues within the brain and spinal cord, peripheral nerves, or muscles that could be causing the headache.

Figure 1:

Differential Diagnosis Flow Sheet


Young, N. P., Philpot, L. M., Vierkant, R. A., Rosedahl, J. K., Upadhyaya, S. G., Harris, A., & Ebbert, J. O. (2019). Episodic and chronic migraine in primary care. Headache: The Journal of Head and Face Pain59(7), 1042-1051. https://headachejournal.onlinelibrary.wiley.com/doi/abs/10.1111/head.13543

Peres, M. F. P., Swerts, D. B., de Oliveira, A. B., & Silva-Neto, R. P. (2019). Migraine patients’ journey until a tertiary headache center: an observational study. The journal of headache and pain20(1), 5-8. https://link.springer.com/article/10.1186/s10194-019-1039-3

Evans, R. W. (2019). Diagnostic testing for migraines and other primary headaches. Neurologic clinics37(4), 707-725. https://www.neurologic.theclinics.com/article/S0733-8619(19)30072-6/abstract

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Published On: 01-01-1970

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