Handbook of Headache, 2nd edition

Handbook of Headache, 2nd edition

by Randolph Evans and Ninan Matthew, 417 pp., Lippincott Williams & Wilkins, 2005, $45.00

Aside from being one of the most common chief complaints seen by neurologists, headaches can be one of the most challenging to diagnose. The differential diagnosis ranges from benign conditions, such as tension headache, to life-threatening conditions, such as subarachnoid hemorrhages. This text is an excellent overview of the diagnosis and management of a broad range of primary and secondary headache disorders.

The first chapter should be read by all first-year neurology residents in the beginning of their training. It gives an overview of the international classification of headaches, strategies for evaluating headaches, and a brief synopsis of the major headache conditions further detailed in the rest of the text. The chapter is set up such that readers could simply look at the tables if they quickly needed a refresher. The end of the chapter concisely addresses medical–legal issues surrounding headache, which are often difficult to find in other headache texts.

The remainder of the book is set up in more of a reference manner, with fewer tables and lengthier text. Each chapter remains brief, and the clear writing style makes for a quick and easy read. Throughout the book, path physiology and pharmacokinetics are discussed in a clear manner. There are excellent references throughout the book. The authors name multiple major studies that support their evaluation and management of different headaches. Although they frequently compare different medications, such as the many different triptans available, there is no sense of author bias toward a specific medication.

There is a chapter on headaches in children that remains very basic and is more of a brief overview than a reference. There is a particularly useful chapter on headaches associated with trauma and concussive syndromes. The book contains a headache diary, which can be useful in a practitioner’s clinic. There is a 35-question quiz at the end of the book to help readers identify the areas in which their knowledge is weaker. There is also a 42-case style quiz with references to which chapter addresses each particular headache syndrome. These quizzes could also be taken before reading the book, to help the reader identify which chapters to study more thoroughly. The cases could also be used to help teach medical students who have less exposure to outpatient neurology.

Overall, this book is an easy read, a concise but complete headache reference, and fills a useful niche in the practice of neurology. However, the practitioner must understand that this book remains a more useful text for the outpatient setting. Common headaches situations seen in the emergency room, such as algorithms for status migrainosus management and when to image pregnant patients with headaches, are missing.

I strongly recommend this text for all neurology residents, private practitioner neurologists, and primary care physicians. It is an essential quick reference text to use in outpatient settings.