Practices of an Inpatient Headache Center

In this article, the author summarizes his experience during 30 years of operating an inpatient headache center. He highlights the following “lessons from experience.”

Chronic headaches are diagnosed by exclusion, and neurologic workups to exclude secondary headaches are often incomplete prior to inpatient admission. Regardless of the etiology, when chronic headaches occur, the author integrates behavioral techniques into the treatment plan. The clinician must evaluate the meaning of head pain to both the sufferer and those around him or her. Clinicians must also identify the “problem patient,” who has important behavioral disorders and who often uses the headache condition to manipulate others. Cluster B personality disorder is overrepresen…