Headaches -- they affect us all. But when the problem is recurrent enough to drive your patient to tell you about it, there are a variety of effective management options. Accurate diagnosis is key. Help here.
A sudden severe headache with emesis brings a 35-year-old man to the ED. Research on his smart phone has satisfied him that this is a post-coital event and therefore, harmless. He refuses a lumbar puncture.
The sphenopalatine ganglion (SPG) has recently been the target of a novel treatment for patients with cluster headaches. A sham-controlled randomized study of an implantable stimulator of the SPG offers encouraging preliminary results.