A systematic review of spontaneous intracranial hypotension demonstrates heterogeneity in clinical and radiographic presentations. Diagnostic studies, such as brain imaging and lumbar puncture, may be unrevealing, and the clinician may have to rely on symptom patterns alone to make a diagnosis.
Prednisone, given at 100 mg for five days and then tapering by 20 mg every three days, is a safe and effective short-term prevention for episodic cluster headaches while waiting for longer-acting preventive agents to be initiated.
Primary headaches, especially migraines, are a common problem for adults and children who present to the emergency department. Migraine headaches have been challenging to diagnose, especially in the pediatric population.
Patients with migraine who have an insufficient response to acute treatment medications, including triptans, risk developing medication overuse headache (MOH). The most successful treatment for MOH is withdrawal of the offending acute pain medications combined with early use of a migraine preventative medication.