What is the recommended action after suspecting migraine headaches in a patient with no significant neurological findings?

In the case of a patient suspected to have migraine headaches without any significant neurological findings, the recommended action is to forgo additional diagnostic testing. This approach is based on the understanding that migraines are primarily a clinical diagnosis, characterized by specific symptoms such as unilateral, throbbing headache, sensitivity to light and sound, and possibly nausea or vomiting.

When assessing patients for migraine, a thorough history and physical examination are usually sufficient to confirm the diagnosis, especially in the absence of concerning neurological signs, which may indicate the need for further investigation. The presence of normal neurological findings generally means that more invasive procedures like CT scans or radiographs are unnecessary and that the likelihood of a secondary cause, like a structural brain anomaly or an acute intracranial process, is low.

Therefore, in a typical case of migraine without red flags, it is both reasonable and practical to treat the patient based on the clinical assessment rather than subject them to additional tests that may not change the management approach. This method reduces healthcare costs and avoids unnecessary exposure to radiation from imaging studies.