A 24-year-old woman is evaluated in the office for headache that occurs once or twice a week. The pain is a constant pressure in the back of the head.

Subject
Medicine
System
Cardiology & Vascular System

Kathryn

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Jul 29, 2020
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A 24-year-old woman is evaluated in the office for headache that occurs once or twice a week. The pain is a constant pressure in the back of the head. She has no nausea and can continue to work during the headaches. She has had these headaches since age 13 years and notes that they now seem to be more frequent and associated with less sleep and increased stress. When treated with ibuprofen or acetaminophen, the headaches abate in 30 minutes; untreated, they last several hours. She typically uses headache medication four to six times per month.
On physical examination, vital signs are normal. All other findings from the general physical examination findings, including those from a neurologic evaluation, are normal. Which of the following is the most likely diagnosis?

(A) Chronic daily headache
(B) Cluster headache
(C) Migraine headache without aura
(D) Tension-type headache
 
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