Review of the patient’s history indicates that the patient has a history of headaches. More often, during the span of a headache, the patient experiences nausea and vomiting. The patient also mentions that light seems to worsen the situation. Therefore, to remedy the problem, the patient usually takes two over-the-counter Motrin and sleeps in a darkened room. Possible diagnosis includes cluster, tension, or secondary headaches. According to Rossi, Whelan, Craven, and Ruiz De La Torre (2016), cluster headache is among the worst pains to human beings. This type of head pains is most common in men. It occurs for a given period during which the patient experiences recurrent pains. The main symptom is an excruciating stabbing pain of very high intensity. A cluster headache occurs in the temporal area in and around the orbit (Rossi et al., 2016). Patients who are suffering from tension-type headache experience a feeling of a tight band around the head. According to Chowdhury (2012), the tension-type headache does not involve nausea and vomiting. Patients with secondary head pains often suffer from other underlying causes or illnesses. A secondary headache occurs when the underlying disease is the primary cause of the situation (Schankin & Straube, 2012). In this case, the patient has other accompanying symptoms and does not have an underlying illness.

The patient experiences nausea and vomiting. These symptoms rule out a tension-type headache. The lack of an underlying illness rules out a secondary problem. Also, the patient does not experience a stabbing pain.  The lack of stabbing pain shows that the situation could not be a cluster headache. Thus, according to the symptoms, the correct diagnosis is a migraine. According to Weatherall (2015), patients suffering from migraine experience headaches lasting for more than four hours if untreated. The aches are pulsating, severe, and cause avoidance of physical activities. The patient may also experience nausea and photophobia. In this case, the patient expresses most of the symptoms of a migraine. Treatment using over the counter medicine is often useful. Some of the available drugs are paracetamol 1g, Triptans, Aspirin 900-1200mg, and Naproxen 250-500mg among others. In this case, it is essential to investigate the triggers. Also, the patient could use the first line preventing medicine such as Propranolol 10mg three times a day (Weatherall, 2015). This is one of the three stages of prevention treatment.

References

Chowdhury D. (2012). A tension-type headache. Annals of Indian Academy of Neurology, 15(Suppl 1), S83-8. doi: 10.4103/0972-2327.100023

Rossi, P., Whelan, J., Craven, A., & Ruiz De La Torre, E. (2016). What is a cluster headache? Fact sheet for patients and their families. A publication to mark Cluster Headache Day 2016. Functional Neurology, 31(3), 181-3.doi: 10.11138/FNeur/2016.31.3.181.

Schankin, C. J., & Straube, A. (2012). Secondary headaches: Secondary or still primary? The Journal of Headache and Pain, 13(4), 263-70.doi: 10.1007/s10194-012-0443-8.

Weatherall M. W. (2015). The diagnosis and treatment of a chronic migraine. Therapeutic Advances in Chronic Disease, 6(3), 115-23.doi: 10.1177/2040622315579627

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