Skill Checkup: A 21-Year-Old Woman Presents With a Severe, Localized Throbbing Headache and Lightheadedness

Helmi L. Lutsep, MD

February 10, 2022

The Skill Checkup series provides a quick, case-style interactive quiz highlighting key guidelines- and evidence-based information to inform clinical practice.

A 21-year-old female patient presents with a severe, localized throbbing headache and lightheadedness. She is nonfebrile. Her height is 5 ft 5 in and weight is 148 lb (BMI 24.6). The patient has begun keeping a headache log, reporting that for the past several months, about half of her days have been headache days. These episodes have begun to affect her academics and social life. As a student, she notes that her symptoms often come on "at the worst possible time" shortly before exams and major assignments. The patient takes nonsteroidal anti-inflammatory drugs (NSAIDs) at the first sign of these episodes, a symptom that she describes as vision sensitivity. But even with increased dosage, they have not been able to curtail the current attack, which has been progressing for over a day and has become diffuse.

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Cite this: Helmi L. Lutsep. Skill Checkup: A 21-Year-Old Woman Presents With a Severe, Localized Throbbing Headache and Lightheadedness - Medscape - Feb 10, 2022.

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