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Schedule: Plan to contact Wade Cooper ahead of your rotation to confirm details. Below is typical schedule as of 2018.

AMSchultz or Cornblath Taubman ClinicCooper Burlington ClinicConferencesCooper Brighton ClinicCooper Burlington ClinicNo clinical duties*
PMSchultz or Cornblath Taubman ClinicCooper Burlington ClinicContinuity clinicCooper Brighton ClinicCooper Burlington ClinicNo clinical duties*

* May be on jeopardy or random nights during this rotation

Typically 1/2 day off is on Monday (morning or afternoon)

Schedules: BRL PAIN NEUROLOGY (Burlington), BCSC PAIN NEUROLOGY (Brighton)

Migraine Evaluation

Migraine Treatment

Strategies to deal with chronic headaches

Headache Journal - 2015 Acute Migraine Therapy Evidence

AAN Practice Guidelines for Migraines (from Neurology 2000; 55:754 - Exhaustive list of things to try)

IHS Classification of headache syndromes

Dangerous Causes of Headache

  • Suspicion for any of the below should increase with worst headache of life, new-onset headaches, or focal findings on exam
  • SAH (worst headache of life)
    • CT
    • LP
  • Epidural, subdural, intraparenchymal hemorrhage
  • Neoplasm
  • Infection/Meningitis
  • Venous sinus thrombosis
  • Pituitary apoplexy
  • Hypertensive encephalopathy
  • Spontaneous intracranial hypotension
  • Stroke
    • Ischemic stroke often presents with headache
  • Dissection
    • Dissection may present with neck or occipital pain
  • Temporal arteritis
    • Consider in all patients over 50 years old with a new headache
    • Elevated ESR (not sensitive!)
    • Symptoms:
      • Palpable pain over temporal artery or jaw
      • Jaw claudication
      • Scalp tenderness
      • Joint aches
      • Temporal bruit
    • This is an emergency! Visual loss can result, and other eye can become involved.
    • Treat with steroids if suspected.
    • Ophthalmology consult.
    • Consider temporal artery biopsy.

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