Headaches in a 15-Year-Old and Incidental Unruptured Aneurysm
Headaches in a 15-Year-Old and Incidental Unruptured Aneurysm
Her headaches likely fall on a migraine spectrum, although they perhaps have evolved into a chronic nonprogressive daily headache picture. The results of an elemental neurologic examination were normal, showing no evidence of cranial nerve or other problems. Her history of a fairly sudden onset of headache and occasional early-morning headaches, although without nausea, vomiting, or increased pain with the Valsalva maneuver, is somewhat concerning, although normal findings of a neurologic examination makes ominous findings such as a tumor unlikely. Because of her symptoms, brain magnetic resonance imaging (MRI) was discussed. We also spent the remainder of a 60-minute appointment discussing headache hygiene, and she agreed make a concerted effort to improve her self-management skills.
Impression
Her headaches likely fall on a migraine spectrum, although they perhaps have evolved into a chronic nonprogressive daily headache picture. The results of an elemental neurologic examination were normal, showing no evidence of cranial nerve or other problems. Her history of a fairly sudden onset of headache and occasional early-morning headaches, although without nausea, vomiting, or increased pain with the Valsalva maneuver, is somewhat concerning, although normal findings of a neurologic examination makes ominous findings such as a tumor unlikely. Because of her symptoms, brain magnetic resonance imaging (MRI) was discussed. We also spent the remainder of a 60-minute appointment discussing headache hygiene, and she agreed make a concerted effort to improve her self-management skills.
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