4.8.1 Probable nummular headache

A delivery driver reports a localized headache located on the crown of his head, present for three months. He describes a well-demarcated patch of discomfort there and says the edge of this area is sharply marked. When asked to draw its outline, he produces a neat, rounded shape rather than anything irregular, describing it as looking like a small egg on his scalp. He reports that the patch keeps exactly the same shape and has not altered in outline since it started three months ago. He could not, however, give me a confident measurement of its extent, and repeated questioning did not settle on any particular span across the patch. He denies photophobia, phonophobia, or associated nausea.