A 7-Year-Old Girl Is Brought to Clinic Due to a Diffuse

A 7-year-old girl is brought to clinic due to a diffuse headache.  She first developed pain while working on a math assignment today.  The headache was exacerbated by the sound of her classmates yelling at recess.  She was permitted to lie down in a dark, quiet room, which helped.  The patient had just returned to school today after a vacation, during which she hit her head on the passenger door when her mother's car collided with another car.  The patient did not lose consciousness and was taken to the emergency department, where head imaging was normal.  Since the incident, she has been more irritable at times.  Vitals signs are normal.  The patient has a normal affect and can easily recall details of the accident.  Examination shows return of headache when asked to move her eyes left and right rapidly between 2 points held a short distance away.  Neurologic examination is otherwise normal.  Which of the following is the most likely cause of this patient's symptoms?

A) Acute stress disorder
B) Concussion
C) Migraine headache
D) Perilymphatic fistula
E) Tension headache

Correct Answer:

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