Evaluation
Brigham and Women’s headache specialists at the John R. Graham Headache Center provide comprehensive evaluation for all types of headaches, including migraine, tension-type headache, cluster headache, chronic daily headache syndrome and secondary headache. Evaluation begins with a detailed history and neurologic examination, and further workup may also include specialized imaging, lab work and lumbar puncture (spinal tap) if indicated.
Information from the American Headache Society
Treatment
Treatment options may include preventative medications, symptomatic medications (also called acute or abortive medications) and recommendations for non-drug therapies. We also perform botulinum toxin (Botox) injections, occipital nerve block procedures and trigger point injections. We provide acute outpatient treatment for selected patients through our Outpatient Infusion Program. Treatment is individualized and depends on the underlying condition causing the headache.
Specific treatment for headaches will be determined by your physician based on:
- Your age, overall health and medical history
- Type of headaches
- Severity and frequency of the headaches
- Your tolerance for specific medications, procedures or therapies
- Your opinion or preference
Adequate headache management also includes lifestyle changes such as:
- Avoiding known triggers, such as lack of sleep, dehydration and missing meals
- Changing eating habits
- Exercise
- Resting in a quiet, dark environment
- Stress management techniques
Rarely, some headaches may require immediate medical attention including hospitalization for observation, diagnostic testing or even surgery.
In light of several recent news items about the growing use of surgical interventions in migraine treatment, the American Headache Society has issued a statement on Migraine Surgery.
American Headache Society Urges Caution in Using Any Surgical Intervention in Migraine Treatment
Follow-Up
We are a primarily consultation-based practice, and patients are usually returned to the care of their referring physicians immediately after the initial evaluation is complete. Patients are sometimes followed for one or two sessions after the initial evaluation to track response to treatment. Patients receiving botulinum toxin injections or other specialized treatments may be followed primarily at the John R. Graham Headache Center. Unfortunately, we are unable to supervise narcotic treatments.
