Headache

Headache Benign
MDM *** who presents with Headache.  *** Most likely 2/2 tension headache or headache of non-emergent etiology. No focal neurological symptoms. Neuro exam is benign. Pt is nontoxic. VSS.  Unlikely SAH: headache is non thunderclap. Headache is gradual, non-maximal at onset and similar to headaches in the past.  Unlikely Subdrual/epidural hematoma: no history of trauma, *** anticoagulation. Unlikely meningitis: afebrile, no meningismus, ***photophobia. Unlikely temporal arteritis: pt < 60 years old.  no tenderness in temporal area, *** ESR.  Unlikely Acute angle glaucoma: PEERL, IOP b/l < 20.  Unlikely Carbon Monoxide Poisoning: no other house members with similar symptoms.

Plan: Will give pain medication and reexamine

Reassessment
Patient headache has improved after medication.  Repeat neurological exam benign.

Discharge instructions
You came to the ER because you had a headache.  You were evaluated and your headache was not concerning for an emergent cause.  We gave you medication to help alleviate your symptoms and you felt better.  You should follow up with your primary care doctor to further evaluate your symptoms.  However, if you symptoms worsen or do not improve, please come back to the ER.