Headache

This condition is treated in the Neurology clinic.

Pre-referral work-up

History

All referrals should comply with referral standards

In particular:

• Onset
• Severity
• Duration
• Pattern

Also the:

• Family history
• Current medications and medications trialled
• History of trauma/travel
• Past history especially of malignancy or recent systemic symptoms
• Impact on life/work

Tests

Tests to consider:

• ESR
• FBE
• UEC
• BSL
• CT Brain

Interim/GP management

To refer a patient with this condition, please see the Neurology clinic page for the full referral process and templates.

• Consider asking patient to keep a headache diary to record frequency, duration, relieving and aggravating factors.
• In patients with frequent migraine consider trialling a migraine prophylactic drug such as amitriptyline or propranolol prior to review at an adequate dose.
• Avoid opiates (including tramadol and codeine) for management of headache due to the potential to develop medication overuse headache.

Direct link to Health Pathways - Headache page

For more information please see the HealthPathways Tasmania website.

International Headache Society

Headache Australia

Cluster Headache Australia

Headache Diary Template

Clinic appointments

? Red location flags are clinical indicators of possible serious underlying conditions requiring further medical intervention. They may or may not indicate an emergency.

Emergency

? Thunderclap onset/very sudden severe onset

• Consider SAH, pituitary apoplexy, haemorrhage into mass lesion

? Signs and Symptoms of meningoencephalitis

• Fever, neck flexion stiffness, rash

? First headache with focal neurological signs or symptoms (consider stroke)

If you, or someone else, are experiencing a serious and life-threatening injury or illness call triple zero (000) immediately or go to the nearest Emergency Department.

Learn more about when to access emergency care and non-emergency care options if the injury or illness is not serious or life-threatening.

Urgent (Category 1)

? Older person (over 50 years) with systemic symptoms and high ESR -  consider temporal arteritis

? Signs or symptoms of raised intracranial pressure such as papilloedema

? New onset in patient with immunosuppression or malignancy (consider meningitis, abcess or metastasis)

We will endeavour to see these patients within two weeks.

Urgent referrals should be accompanied by a phone call, as per below:

• Contact the Neurology Registrar directly within hours via the RHH switchboard Phone: (03) 6166 8308

Availability

North

Launceston General Hospital
Level 3 - Specialist Clinics

Phone: 1300 977 694
Fax: 03 6777 5227

North West

Unavailable.

South

Wellington Clinics
Phone: 03 6166 0000
Fax: 03 6173 0491