| Orthopaedic Rehabilitation -
| Headaches & Migraine -
Classification of headache :
- Vascular(migraine/cluster/aneurism)
- Tension(muscle contraction)
- Pressure/Inflammatory(brain tumor,infection, cva)
- Cranial neuralgias(trigrminal neuralgia,dysfunction of TMJ/assoc muscles)
- psychotic (usually delusional ie. feels worms inside their head)
Headache Case History Taking Sieve
where is the pain?
What type of pain?
How severe is the pain?
What is the duration?
What is the onset?
What is the frequency?
Is it acute or chronic and re-occurring?
If chronichas it changed its characteristics or become progressively severe?
Does the pain occur at the same time every day
Does coughing and sneezing or changing the position of the head affect the headache?
Painful structures in the head
INTRACRANIAL
Venous sinuses
Cortical veins
Basal arteries
Dura of anterior,middle and posterior fossa
EXTRA CRANIAL
Scalp vessels
Scalp muscles
Orbital contents
Mucus membranes-para/nasal
External and middle ear
Teeth and gums
Examination
Active/ passive movements of the cervical spine/temporomandibular joint
Compression
Blood pressure
Eye/vision examination
Neurological examination including cranial nerve testing
Tap over frontal and maxillary sinuses(if u suspect sinusitis)
Kernig’s sign
Vertebro basilar insufficiency
Migraine
There are a number of trigger factors causing a migraine headache and these can range from the following
Chemical toxins
Various E numbers
Red wine
Cheese
Chocolate
Bright light