Menarche Case Study

No history of skin disease. Skin is pink, dry, and void of bruising, rashes, or lesions. No recent hair loss; head is normocephalic. Pupils equally reactive to light; no history of glaucoma or cataracts. Ears are in normal alignment; no history of chronic infections, hearing loss, tinnitus, or discharge. Nose and sinus history includes clear nasal discharge “since last October”, and occasional nose bleeds; states she use to get nose bleeds often as a child. Mouth and throat are absent of lesions; no bleeding gums, sore throat, dysphagia, hoarseness, or altered taste. Neck is void of pain, swelling,

L.H. report no concurrent or severe headaches; There was no head trauma, syncope or vertigo. Patient wears corrective lens with no difficulty of vision or diplopia; absent of inflammation, discharge or lesion. Last eye exam was in September of 2016 with no history of glaucoma, cataracts. L.H. denies having any frequent colds, sinusitis, epistaxis and trauma. Patient reports having obstruction stating, “it happens when I am lying down” with an occasional postnasal drip.

Patient is a 60-year-old Latin American female, who presents with her husband for evaluation of some spells. She seems to have two different things going on. She did report intermittent episodes of feeling of weakness with blurred vision, diffuse paresthesias and a sensation she is about to pass out or the sensation of before undergoing generalized surgery, feeling like she is being sucked down. There is no loss of consciousness with this. She is unable to give any further history, except these events have been going on for about a month. They are almost daily. She does note they happen after eating, at which point, she will fall asleep easily. Otherwise, she denies any loss of consciousness,

She reports a history of back pain, ovarian cysts excision, and breast tumor. She denies chest pain, shortness of breath, or palpitations. Patient reports that her immunizations and preventive care are up to

Patient is a 34-year-old left-handed white male who states that in January he was in a parking lot and was hit by a plow truck that was backing up. His back was turned and he did not know what was happening. He fell on his back and hit the back of his head on the tailgate. He denied any loss of consciousness. He did have a significant headache and neck pain, but no neurological symptoms. He did have some pain in his right hand and right ankle after this. He did present to the emergency room, where an unenhanced CAT scan was negative. Since then however, he has been having daily headaches. He has an almost constant, dull, mild bitemporal pressure sensation, but he also has significant

The patient denies having any history of CNS infection or already significant systemic infections. He has never had any thunderclap headaches, or any left-sided neurological symptoms. He does recall having a marked headache during the flight in the 1980s and one recent exertion-induced headache last fall, lasting 15 minutes. Otherwise, he gets mild headaches and aches and pains for which he does occasionally take aspirin. There is no family history of aneurysms. His father did die of a brain tumor, which the patient called the primary "Astro something". It was not metastatic. The patient says his ENT is aware of the nasopharyngeal mass and has called it polyps. The patient also has history of bradycardia and occasionally when he takes his pulse and he finds that it is irregular. He has an evaluation with a cardiologist coming up to rule out atrial fibrillation. He also has a family history of what may be a benign essential tremor. His father a couple of paternal uncles had this tremor. He has had it for years. It has slowly increased over the years, but it still is intermittent to high frequency, low amplitude, mostly action

The 32 year old patient is presenting with chronic headaches. Subjective data indicates over the eye throbbing or pressure that spreads to the ipsilateral temple which typically occurs on the left side. This headaches occur with extremely light and sounds which become aggravated with movement. Given this information, it is necessary to explore additional questions. According to Guilbea and Lenahan (2015) the health history questions are key to making a diagnosis as it will help to rule out another diagnoses. They questioned presented to the patient are listed below. Question one will identify whether the headache is primary or secondary. Using the well-established PQRST pain method, the questions are designed based on this method. For question two the P aspects of pain which stands for provocating and precipitating factors. In question three, the Q stands for quality of pain. Question four addresses the R which stands for radiation. The patient did report it moves which is an area that requires further

To finish the discussion of the different types of headaches is an exploration of research associated with cervicogenic headaches. Classified as a secondary headache, cervicogenic headaches are defined as a disorder originating in the cervical region that develops in the head/face region. This includes involvement from any cervical musculature as well as bony, disc, or other soft tissue structures. Characteristic symptoms of cervicogenic headaches include unilateral pain without side-shift, elicitation of pain with external pressure over the ipsilateral upper neck, limited cervical range of motion, and the triggering of attacks by various awkward or sustained neck movements (Dunning et al., 2016). In regards to abnormal movements of the neck,

The American Migraine Study II was a follow-up study conducted in 1999 to describe the prevalence, sociodemographic profile, and impact of migraine in the United States compared to the previous study in 1989. A questionnaire was mailed to 20,000 households to identify International Headache Society criteria-based migraine sufferers. Of 43,527 age-eligible individuals, 29,727 responded to the questionnaire, for a 68.3% response rate. Twenty-three percent of respondent households had at least one member with migraine. Since the 1989 study, migraine sufferers have increased by 4 million which is consistent with population increase. (20) In total, about 2% of the adult population has chronic migraine with over 80% going undiagnosed with this disorder. (3)

Headaches are common conditions which are seen in 66% of the global population, therefore causing disturbance to both quality of life (QoL) and psychosocial state (Stovner, L., et al. 2007). Cervical Headache or more commonly known as Cervicogenic headache (CGH) is mainly characterized by unilateral headache symptoms which arise from the cervical spine radiating to the fronto-temporal and possibly to the supraorbital region (Pfaffenrath, V. and Kaube, H. 1990; Nilsson, N. 1995). There is controversial evidence on the strict definition of CGH, with some criteria’s including; unilateral headache, neck pain or neck trauma injury (whiplash), reduced cervical range of motion. Although prevalent

In order to understand the nature of Sally’s headaches it is imperative to ask a series of questions to narrow the focus of the cause. To find out of the headaches are sudden or chronic is important, asking such questions as, how long ago did the headaches start? Is the onset sudden or gradual? How long to they normally last? Are there any aggrieving factors? Any thing that makes them better? Describe the pain? Have you tried any over the counter medications if so do they help? A complete review of systems and review of all (If any) medications sally maybe talking can reveal any causes.

Following an emergency call to the Out of Hours Doctor by the lady’s niece, a 999 ambulance was requested. She was admitted with symptoms of severe sudden onset of frontal/occipital headache which radiated to the neck, acute rotational vertigo, heart palpitations, shortness of breath, weakness and paraesthesia in all four limbs, photophobia, blurred vision and vomiting. Past medical records indicated that the patient is prone to migraines and has previously known hypertension, fibromyalgia, asthma and chronic obstructive

• Headaches that develop and recur on one side of the head and around the eye (cluster headaches).

A 22-year-old healthy male presented to the ER on account of severe bilateral headache during intercourse. Physical examination was unremarkable and CT head was negative. He represented a week later with headache, and unwitnessed syncopal episode. He developed left facial, arm numbness and weakness during hospital evaluation. Physical examination revealed intact cognitive function and a focal left sided neurology deficit.

She is not currently on any medication/supplements/vitamins. She was using Microgynon 30 ED (combined oral contraceptive pill) from April 2011 to June 2015