1.1 Migraine without aura

A 46-year-old chef reports headache attacks that have not settled despite simple analgesia. He describes a severe, throbbing pain that builds over an hour or two, and during the worst attacks he vomits, usually once, which brings some relief. His most recent attack ran for a full 38 hours before it eased. He counts at least five such episodes since they began roughly a year ago, occurring irregularly, sometimes weeks apart. He reports no limb weakness and no fevers. He works long shifts in a hot kitchen and wonders whether heat or dehydration might be a factor, though attacks have also occurred on days off.