A Pain in the Brain

This interactive feature presents the case of a 54-year-old woman with a history of mild, intermittent headaches who awoke from sleep with a squeezing, stabbing pain around her entire head. Test your diagnostic and therapeutic skills at NEJM.org. A 54-year-old woman presented with a headache that had started 8 days earlier. She had awoken with stabbing, squeezing pain around her entire head. She rated the pain at 10 on a scale of 0 to 10 (known as 10/10), with 10 representing the worst pain imaginable. The pain was not alleviated by nonsteroidal antiinflammatory drugs (NSAIDs). She reported having had no headache on going to sleep . . .