4.6.2 External-traction headache

A 51-year-old man reports a headache during an evening performance, which he says is now at least the sixth such episode this theatre run. He wears a heavy wig secured with combs and tape that pulls steadily on his scalp throughout each two-hour show, and he reports the pain settling exactly where the combs grip his hair at the crown rather than anywhere else. Tonight's headache came on part-way through the first act while the wig was pinned tightly in place, and it eased within the hour of removing the wig backstage afterwards. He denied vomiting, denied visual disturbance and denied any weakness or slurred speech. There is no family history of headache disorders.