Severe Headaches in a 28-Year-Old
Female – Migraine with Aura
Comprehensive i-Human Case Study –
Week 7
Patient: Young Adult Female
Chief Complaint: “I keep getting severe headaches with visual disturbances.”
Setting: Outpatient Primary Care Clinic
, Patient Introduction
The patient is a 25-year-old female presenting with recurrent, severe headaches occurring for
the past 6 months, associated with visual disturbances (aura). She reports increasing frequency
and intensity of headaches over the last 3 months. She appears alert, oriented, and in mild
distress due to headache pain.
History of Present Illness (HPI)
The patient describes her headaches as:
• Location: Unilateral, right temporal
• Quality: Throbbing/pulsating
• Severity: 7–9/10 on a pain scale
• Duration: 4–72 hours per episode
• Frequency: 1–2 times per week recently, previously 1–2 times per month
• Associated Symptoms: Nausea, photophobia, phonophobia, visual aura (flashing lights,
zigzag lines)
• Aggravating Factors: Stress, bright lights, lack of sleep
• Relieving Factors: Rest in a dark, quiet room, NSAIDs (ibuprofen) provide partial relief
• Onset: Gradual onset of aura followed by headache
She denies: syncope, fever, recent head trauma, neurological deficits outside aura, or sudden
“worst headache of life” episodes. No family history of brain tumors. She reports no use of
hormonal contraceptives.
Review of Systems (ROS)
General: Fatigue during headache episodes; denies weight loss, fever
HEENT: Positive for visual aura; denies eye pain, blurred vision outside aura
Neurological: Positive: tingling in fingers preceding headaches; denies weakness, numbness,
dizziness unrelated to aura
Cardiovascular: Denies chest pain, palpitations
Respiratory: Denies cough, shortness of breath
Gastrointestinal: Nausea present during headaches; no vomiting outside episodes
Musculoskeletal: Denies neck stiffness or joint pain
Psychiatric: Mild anxiety related to headache episodes
Skin: No rashes