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Medical Author:

Benjamin Wedro, MD, FACEP, FAAEM

Benjamin Wedro, MD, FACEP, FAAEM

Dr. Ben Wedro practices emergency medicine at Gundersen Clinic, a regional trauma center in La Crosse, Wisconsin. His background includes undergraduate and medical studies at the University of Alberta, a Family Practice internship at Queen's University in Kingston, Ontario and residency training in Emergency Medicine at the University of Oklahoma Health Sciences Center.

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Medical Editor:

Charles Patrick Davis, MD, PhD

Charles Patrick Davis, MD, PhD

Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.

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When a patient who has a headache presents for medical care, the concern in the back of the physician's mind is whether an aneurysm exists and has ruptured. Because up to half of aneurysms have a sentinel leak prior to completely rupturing, the first headache presentation is an opportunity to intervene and potentially prevent that rupture.

If the patient is awake, alert, and oriented, there is time to ask questions and learn about when the headache started, where it is located, and if there are any other associated symptoms like nausea, vomiting, change in vision or hearing, weakness, numbness, and neck pain.

If the patient is lethargic or not completely awake, initial steps will include evaluation of the ABCs of resuscitation (or CABs, according to new resuscitation guidelines) -- airway, breathing, and circulation -- to make certain that the patient is stable before proceeding any further.

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