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A 35-year-old woman presents to the clinic with headaches. Her past medical history is significant for migraines and a sprained ankle four months ago that she has been managing with daily NSAIDs. Her headaches started a month ago and have been occurring every day for the past three weeks. She describes the headaches as a band-like pressure around her head. Nothing has helped but the symptoms are worse in the mornings. A recent brain MRI was completed during an emergency room visit which was unremarkable. Which of the following is the most appropriate next step in therapy?
All of the following therapies can be useful in the management of cluster headaches except:
A 55-year-old male cigarette smoker with a past medical history of hypertension and medication non-compliance presents to the emergency room with an excruciating headache and altered mentation. An MRI of the brain is completed and provided below (T2 sequence). Which of the following is the most likely diagnosis?
A 40-year-old man comes into the clinic with headaches. He has stabbing pain around the left temple that occurs numerous times during the day. The pain lasts 10-30 seconds at a time. He says he has excessive tearing from the left eye during these episodes. What is the most appropriate therapy?
Which of the following is not typically treated with indomethacin?
Which of the following has the longest half-life?
A 5-year-old female was brought to the neurology clinic for a second opinion for paroxysmal spells of dizziness. The family states that several times a month the patient will develop severe dizziness, nausea, and vomiting. Symptoms usually only last less than 5 minutes. An MRI and 24-hour ambulatory EEG have been performed in the last 3 months. Both were unremarkable. What is the most likely diagnosis?
A 40-year-old man is seen in the clinic with the chief complaint of headaches. He endorses a unilateral stabbing-like pain around the temple. This pain lasts 10-30 seconds at a time and occurs dozens of times a day. There were no clear triggers. There is associated ipsilateral conjunctival lacrimation and rhinorrhea. What is the most likely diagnosis?
An overweight 24-year-old woman complains of neck stiffness, daily headaches, and blurred vision. She has disc edema on fundoscopic exam and slit-like ventricles on MRI brain. A spinal tap was performed and confirmed the diagnosis. Which of the following is the first-line therapy?
Which of the following headaches is most likely to respond to a combination of caffeine and lithium?
A 30-year-old woman presents to the clinic with severe headaches requesting treatment because she “can’t live with this pain”. Episodes are left-sided, occur multiple times a day, and last about 20 minutes each. During episodes, she will also have eye tearing and rhinorrhea. What is the correct diagnosis?
An MRI is performed on a 30-year-old woman with a 3-day history of intractable headache after a recent epidural and uncomplicated vaginal delivery of a healthy baby girl. Axial T1 pre-contrast (left) and post-contrast (right) MRI images are shown below. Which of the following is the most likely diagnosis?
A 30-year-old woman presents to the clinic with severe headaches requesting treatment because she “can’t live with this pain”. Episodes are left-sided, occur multiple times a day, and last about 20 minutes each. During episodes, she will also have eye tearing and rhinorrhea. What is the appropriate therapy?
A 55-year-old female with a past medical history of coronary artery disease and ischemic stroke with residual mild left arm weakness presents with headaches for a year. Episodes occur two to three times a month. The pain is unilateral and is associated with nausea and photophobia. During this episode, she is unable to go to work and over-the-counter anti-inflammatories have been ineffective. Physical exam and vitals are normal. Which abortive therapy is the most appropriate next step in management?
A 27-year-old female presented with a severe headache for the past 4 days. Last week she gave birth to a healthy baby boy. She says the pain is worse when sitting up or walking but laying down in bed provides some relief. A brain MRI with contrast is ordered which shows thickening and enhancement of the dura. What is the most appropriate therapy for this patient?