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The Practicing Physician's Approach To Headache

Dhirendra S. Bana, MD
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


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The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
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