An Adolescent with Headache: The Power of Anamnesis

Headaches are a frequent reason for medical observation in adolescents. This clinical case illustrates the importance of careful anamnesis, both semiologically and biopsychosocial. We describe a case of a 15-year-old male, with headaches during weekend sports matches. A migraine induced by physical activity was first diagnosed, and the trigger was suspended after medical recommendation, with the resolution of symptoms. He later showed demotivation since he stopped extracurricular sports, adding that he fasted before the matches because of performance anxiety. No episodes were registered during physical education classes and headaches relapsed during the holidays when he skipped breakfast. A migraine induced by prolonged fasting was proposed, with follow-up confirming it. A simple diagnosis can be made upon clinical interview, deeply impacting the patient´s quality of life. Addressing the adolescent’s complaints helped unravel the diagnosis of the correct trigger factor and allowed him to return to his extracurricular activities with better management of his condition.