SEP 23, 2016
Intracranial Pressure/Headache , Neuro-Ophthalmology/Orbit
History questions key to patients with headache:
- Do you have a history of headaches? If yes, is this headache similar?
- Are your headaches associated with specific triggers or do they occur at specific times?
- Does the headache interfere with your usual activities?
- What is the location and character of the headache?
- Does eye movement aggravate the pain?
- Do you have any nausea or vomiting, light or sound sensitivity?
- Does any activity make the headaches worse?
- Have you had any cancer, autoimmune disease, immunosuppression, or seizures?
- Could you be pregnant?
- Have you had weight loss, fever, scalp pain, jaw or tongue pain, or temporary vision loss?
Exam keys in patients with headache:
- Examine lids and orbit for ptosis, proptosis, displacement, and lid retraction.
- Palpate the trochlea.
- Examine pupil for anisocoria and relative afferent pupillary defect.
- Do a motility exam to detect subtle signs of cranial nerve involvement.
- Slit lamp and dilated fundus exam will identify any inflammatory or infectious involvement of the eye or ocular adnexa, and if present, will identify papilledema.