N6647 Neurologic Disorders and Clinical Neurodiagnostics Mastery Examination:
Headache Evaluation History and Temporal Pattern Analysis, Associated
Symptom Identification and Functional Impact Assessment, Tension-Type
Headache Diagnostic Criteria and Musculoskeletal Pain Management, Chronic
Daily Headache and Medication Overuse Rebound Pathophysiology, Cluster
Headache Trigeminal Autonomic Cephalalgia Recognition and Acute Oxygen
Therapy, Migraine Without Aura Diagnostic Criteria and Neurovascular Pain
Mechanisms, Migraine With Aura Cortical Spreading Depression and Visual
Fortification Spectrum Phenomena, Migraine Trigger Identification and Lifestyle
Risk Factor Assessment, Serotonin 5HT1 Agonist Triptan Pharmacotherapy and
Vasoconstrictive Mechanism Safety Considerations, Migraine Abortive and
Preventive Pharmacologic Treatment Strategies Exam Questions Verified and
Provided with Complete A+ Graded Rationales Latest Updated 2026
General approach to the patient with headache
History: Get a careful account by the patient of the current or most recent episode.
Associated Factors: Warning of the attack, triggers, all medications used, What does the patient
attribute the headache to?
Temporal Features: When did the headache begin, start suddenly or gradually, how long does it last?,
time of day, does it awaken the patient from sleep?, frequency.
Character and location: Where is the pain and what does it feel like? 1-10 scale.
general approach to the patient with headache continued
Aggravating & Alleviating Factors: What makes it better or worse?
Environmental Exposures: Does the headache start after any environmental exposure?
,Associated Symptoms: nausea, vomiting, sensitivity to light, sound, and odors. Visual disturbances,
paresthesias, weakness, vertigo, or loss of consciousness. Scalp tenderness.
Prior Evaluation: Has the patient been evaluated for headache in the past?
Disability or Functional Impact: Is there an affect on work, school, social activities, or relationships?
Family History
Headache differential diagnosis
Tension-type headache
Chronic daily headache
Migraine
Cluster headache
Sinus headache
Exertional headache
Pseudotumor cerebri
Giant cell arteritis
Polymalgia Rheumatica
Infection (meningitis)
TMJ Syndrome
Tension-type headache
The most common type of primary headache.
Last 1-14 days.
, At least two of the following characteristics:
1. Bilateral location.
2.Pressing/tightening (non-pulsating) quality.
3.Mild or moderate intensity.
4.Not aggravated by routine physical activity.
Both of the following:
1.No nausea or vomiting.
2.No more than one of photophobia or phonophobia.
Not attributed to another disorder.
Tension type headache continued
People with frequent tension-type headaches seek medical attention and sometimes require
prescription medication.
Chronic type can cause significant disability and distress.
Physical exam is normal.
May have scalp or neck tenderness.
Depression and anxiety have been described as common comorbidities.
Unknown cause.
tension type h/a diagnostics
Depending upon severity
CT/MRI
Sinus series
CBC, CMP, TSH
Cervical Xrays
Headache Evaluation History and Temporal Pattern Analysis, Associated
Symptom Identification and Functional Impact Assessment, Tension-Type
Headache Diagnostic Criteria and Musculoskeletal Pain Management, Chronic
Daily Headache and Medication Overuse Rebound Pathophysiology, Cluster
Headache Trigeminal Autonomic Cephalalgia Recognition and Acute Oxygen
Therapy, Migraine Without Aura Diagnostic Criteria and Neurovascular Pain
Mechanisms, Migraine With Aura Cortical Spreading Depression and Visual
Fortification Spectrum Phenomena, Migraine Trigger Identification and Lifestyle
Risk Factor Assessment, Serotonin 5HT1 Agonist Triptan Pharmacotherapy and
Vasoconstrictive Mechanism Safety Considerations, Migraine Abortive and
Preventive Pharmacologic Treatment Strategies Exam Questions Verified and
Provided with Complete A+ Graded Rationales Latest Updated 2026
General approach to the patient with headache
History: Get a careful account by the patient of the current or most recent episode.
Associated Factors: Warning of the attack, triggers, all medications used, What does the patient
attribute the headache to?
Temporal Features: When did the headache begin, start suddenly or gradually, how long does it last?,
time of day, does it awaken the patient from sleep?, frequency.
Character and location: Where is the pain and what does it feel like? 1-10 scale.
general approach to the patient with headache continued
Aggravating & Alleviating Factors: What makes it better or worse?
Environmental Exposures: Does the headache start after any environmental exposure?
,Associated Symptoms: nausea, vomiting, sensitivity to light, sound, and odors. Visual disturbances,
paresthesias, weakness, vertigo, or loss of consciousness. Scalp tenderness.
Prior Evaluation: Has the patient been evaluated for headache in the past?
Disability or Functional Impact: Is there an affect on work, school, social activities, or relationships?
Family History
Headache differential diagnosis
Tension-type headache
Chronic daily headache
Migraine
Cluster headache
Sinus headache
Exertional headache
Pseudotumor cerebri
Giant cell arteritis
Polymalgia Rheumatica
Infection (meningitis)
TMJ Syndrome
Tension-type headache
The most common type of primary headache.
Last 1-14 days.
, At least two of the following characteristics:
1. Bilateral location.
2.Pressing/tightening (non-pulsating) quality.
3.Mild or moderate intensity.
4.Not aggravated by routine physical activity.
Both of the following:
1.No nausea or vomiting.
2.No more than one of photophobia or phonophobia.
Not attributed to another disorder.
Tension type headache continued
People with frequent tension-type headaches seek medical attention and sometimes require
prescription medication.
Chronic type can cause significant disability and distress.
Physical exam is normal.
May have scalp or neck tenderness.
Depression and anxiety have been described as common comorbidities.
Unknown cause.
tension type h/a diagnostics
Depending upon severity
CT/MRI
Sinus series
CBC, CMP, TSH
Cervical Xrays
