Core IM Podcast: 5 pearls on Headaches - Core IM | Internal Medicine | Medical Education | FOAMed | Family Medicine | Physician Assistant | Resident | Nurse Practitioner | Medical Student | Hospitalist | Primary Care

Core IM | Internal Medicine Podcast

Core IM Team

Mental Health, Education, Health & Fitness, Medicine

4.8 • 1K Ratings

🗓️ 18 October 2017

⏱️ 16 minutes

🔗️ Recording | iTunes | RSS

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Summary

Cement your knowledge on headaches with 5 Pearls on when imaging is indicated, approach to abortive medications, medication overuse headaches, when to use migraine prophylaxis and effective non-pharmacological treatment for migraines! For full shownotes: https://www.coreimpodcast.com/2017/10/18/5-pearls-on-headaches/ (https://www.coreimpodcast.com/2017/10/18/5-pearls-on-headaches/) Time Stamps * What are the indications for imaging for HA? (1:36) * What is your approach to abortive therapy for migraines? (4:45) * How do you diagnose medication overuse HA? (6:41) * What is your approach to migraine prophylaxis? (8:29) * What are some evidence based nonpharmacological therapies for migraines? (10:42) Find the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840 Advertising Inquiries: https://redcircle.com/brands Privacy & Opt-Out: https://redcircle.com/privacy

Transcript

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0:00.0	This is the core I am five burls Podcast brought to you by clinical correlations.
0:15.6	Bringing you high yield evidence-based pearls.
0:18.3	Today we're talking about headaches.
0:20.8	A very special thank you to Dr Minin, a neurologist and a headache specialist who serves on the editorial board of the journal, Headache.
0:28.0	She has peer reviewed this podcast as well as Dr. Vincent's Centillo, an internal medicine physician at NYU.
0:34.7	All right, let's get started with five questions on the pearls we'll be covering.
0:39.2	Number one, indications for imaging in patients complaining of headaches.
0:44.0	What headache features and in which demographics would you consider imaging for headaches?
0:49.0	Number two, abortive therapy in migraines. How do you choose your options for acute treatment of migraines?
1:00.0	Number three, medication overuse headache. At what medication frequencies and what type of
1:09.0	change in the headache do you consider medication overuse.
1:13.0	Number four, migraine prophylaxis.
1:19.0	When you start thinking of putting your patients on preventive therapy for their migraines and what do you start?
1:28.3	Number five, non-pharmacological therapies for migraine. So what are things that are not
1:33.9	medications and have shown to be efficacious for migraines?
1:39.6	Let's jump into it Marty. So the vast majority of headaches a PCP is going to see are going to be primary headaches.
1:48.0	So the majority is going to be tension type about 70% and then 16% of them are going to be migraines, and less
1:55.0	than 1% is going to be the much rarer cluster headache. That being said, we should always
2:00.4	look out for red flags.
2:02.6	For sure, Shreya.
2:04.0	Red flags are clues that there might be a secondary
2:06.8	headache going on, and we might need imaging.
	...

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