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September 16, 1992

The Practicing Physician's Approach To Headache

Author Affiliations

The Faulkner Hospital Boston, Mass

JAMA. 1992;268(11):1472. doi:10.1001/jama.1992.03490110110044

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This "working text" by 18 contributors provides a logical guide to the art of treating headache patients. The experienced authors advise clinicians to lend a sympathetic ear to the headache patient's complaints while taking the history. They recommend checking for hypertension and endocrine disorders, among other things, during the physical examination and methodically discuss the necessary laboratory tests to rule out other conditions that can cause headaches.

The subsequent chapters devoted to migraine and its complicated form and cluster, tension-type, and organic headaches are well illustrated by case histories. The locations of headaches based on the involved underlying structures are documented in considerations of headache in cerebrovascular disease, posttrauma, and eye-, ear-, nose-, and throat-related conditions. Coronal computed tomographic scans visibly delineate the various sinus-related headaches. Drug therapies discussed include some uncommon methods, such as histamine desensitization for intractable cluster headache and even the soon-to-be-released sumatriptan. Also skillfully addressed is