Learning Objectives

  1. Recognize the presence of different headache types co-existing in a single patient
  2. Articulate the impact of psychological stress, medication overuse, poor sleep and other factors on the development and progression of chronic headaches
  3. Describe a comprehensive approach for the treatment and prevention of chronic headaches including pharmacologic measures and behavioral modifications

Target Audiences

  • Medical Students: Years 1-4
  • Nursing Students: Advanced undergraduates; 1st and 2nd year master’s candidates
  • Dental Students: Years 3-4 
  • Physical Therapy Students (DPT): Year 2-3
  • Pharmacy Students: Year 3

Case Description

This case focuses on a patient with headaches and stress.  Teaching points will emphasize essential elements of the history and physical examination in all patients with headaches including psychosocial assessment, evaluation of different headache types (e.g., tension-type, migraine).  Pharmacological as well as non-pharmacological management strategies will be reviewed with an emphasis on behavioral modification strategies to prevent the development of chronic daily headache and, therefore, improve quality of life.

Potential Impact of Case

  1. Improve knowledge: Increase reliance on history and physical examination skills; decrease unnecessary diagnostic testing
  2. Change attitudes: Appreciate the value of pharmacological and non-pharmacological management strategies in managing headaches; appreciate association between stress and headache chronicity
  3. Gain skills: Reinforce patients’ behavioral and lifestyle modifications to reduce headache frequency; prevent the development of chronic daily headache
University of Pittsburgh logo
University of Pittsburgh