MICA · General Practice & Urgent Care
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FICTIONAL CASE · SELF-REFLECTION WITHOUT A SCORE
A man with a history of migraine describes a very severe headache during exertion, immediately different from his usual episodes. He has no weakness or fever. Rest partly reduces the pain.
Does his migraine history justify usual migraine care?
No. Rapid onset and a change from previous attacks require urgent assessment for a secondary cause, particularly vascular disease. No focal deficit and partial improvement are insufficient reassurance. Communicate exact onset time and time to peak intensity without delaying referral to test the response to an analgesic.