This is Steve Carroll and you're listening to the EM Basic podcast.

Today we're going to talk about headache.

This is a complaint that we deal with a lot.

While most causes of headache are benign, we need to be good at picking up the small

percentage of patients who have life-threatening causes for their headache.

Today we'll go over how to take a good headache history, how to do a thorough neurological exam,

how to treat and work up

headache in the ED, and how to avoid missing serious pathology. We're going to limit this

podcast to patients who have a headache and nothing else. We won't be talking much about stroke

syndromes or meningitis. We will be focusing on common headache syndromes and the can't

misdiagnoses that are associated with headache.

There will also be a bonus section on how to do a lumbar puncture and the tricks of the trade for getting it right the first time. So stay tuned for that at the end. The bonus section will make this

longer podcast than usual, but I think it's worth it. As always, this podcast doesn't represent

the views or views or the views or the news, your opinions of the Department of Defense, the U.S. Army, or the Shawshack Emergency Medicine Residency. So let's get started. As always, it's important to read the

triage note and the vitals. Make sure that you address any issues in the triage note. I've been to

several M&Ms where the patient was worked up for headache when they really should have been worked up

for a TIA or stroke. If the patient is complaining

of any syncope, weakness, or slurred speech, or other worrisome findings in their triage note,

you need to be aware of it because it may be the first and last time that you find out

about that part of their history. So let's go through how to take a good history on a patient

with headache. You want to go through all your OPQRST questions about the headache,

but there are a few specific areas that deserve attention. First, ask when exactly the headache

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