Source: Institute for Clinical Systems Improvement (ICSI). Diagnosis and treatment of headache.

Bloomington (MN): Institute for Clinical Systems

Improvement (ICSI); 2007 Jan. 72 p.

Diagnosis and Treatment of Headache

Tension-Type Headache Algorithm
58
A = Annotation
Tension-type
The patient would enter this headache
algorithm from box 18 of the
Diagnosis Algorithm.
59

Patient meets 60
no
criteria for tension- Return to Diagnosis
type headache? algorithm

A
yes
62
61
Acute treatment:
Does patient Acetaminophen
yes
currently have a Aspirin
headache? NSAIDs
Midrin
Adjunctive therapy
A
no

63 65
64 Is patient
no candidate for yes Therapy
Consider referral
Out of guideline prophylactic successful?
treatment?

yes no
66
Adjunctive therapy 62, 66 Prophylactic treatment:
Stress management Amitriptyline
Physiotherapy Other TCAs
Venlafaxine XR
Tizanidine
Adjunctive therapy
A

68
67
Consider other acute or
Therapy no prophylactic treatment
successful? Reconsider diagnosis
Consider medication
overuse
Consider specialty referral
yes

69
Continue therapy

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