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A 28-year-old female presents to your office with a headache that is throbbing and affecting the left-side of her head. She also reports nausea and had one episode of vomiting. Her symptoms began approximately 6 hours ago, where she began to see a bright light that progressively expanded. Resting in a quiet dark room diminished her symptoms. She denies weakness, numbness or aphasia. Patient takes no other medication except for the occasional Tylenol. Medical history is unremarkable. She denies alcohol, smoking, or illicit drug use. How would you approach this scenario? What will be your treatment plan? Does the patient need lab work or imaging tests?

  • 3yr
    It depends if this is the first headache or she has a history of them. This seems like a typical migraine with aura but if it is the first occasion, then she should be worked up for secondary causes. Also need to ask about severity in addition to character.

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