Treatment of headaches and migraines by neurologist Igor Stanislavovich Shkinder in Dnipro

Patients present with headaches, migraines, frequent episodes of head discomfort, or sleep disturbances associated with pain.

The doctor performs a thorough clinical evaluation, reviews the complaints and medical history, and, if necessary, orders additional tests to clarify the causes of the symptoms.

In the end, the patient receives a clear action plan: recommendations regarding their current condition, the necessary examinations, and ways to monitor changes.

Special attention is given to the differential diagnosis of the causes of headaches and the prevention of exacerbations for more effective management of the condition.

When to See a Doctor

Headaches and migraines can appear in different ways, and it is not always easy to understand when professional help is needed. A doctor can help determine the cause of your symptoms, review your medical history, and order the necessary tests for an accurate assessment of the situation. You should make an appointment with a neurologist if, with headaches or migraines, you notice:

• Frequent recurring headache episodes of varying intensity
• Headaches that worsen with physical activity or changes in body position
• Difficulty concentrating due to constant or intermittent headaches
• Headaches that interfere with your ability to work or rest properly
• Sleep disturbances due to frequent headaches or migraines
• No improvement after taking painkillers on your own or after previously prescribed treatment
• Worsening headaches after stressful situations or physical exertion
• Headaches appearing for the first time or changing in character and frequency
• Recurrent symptoms that do not go away for a long time
• A worsening condition after infections or injuries
• Headaches that make it difficult to carry out your usual daily activities
• The need to assess your condition in the presence of accompanying chronic illnesses

If you notice one or more of the signs listed above, a consultation with a neurologist can help identify what is causing the discomfort and determine the most appropriate approach for further monitoring and health support.

Emergency situations, or when you need to see a doctor urgently

• A sudden, very severe headache that is markedly different from previous headaches
• The appearance of weakness or numbness on one side of the body
• Speech impairment or loss of the ability to understand speech
• Sudden problems with coordination or balance
• Loss of consciousness or severe dizziness with a fall

If these symptoms occur, do not wait for a routine appointment — it is recommended to call a doctor to your home immediately to receive prompt care and an assessment of your condition.

Causes and Risk Factors for Headaches and Migraines

Understanding the possible causes of headaches and migraines helps guide evaluation and choose the right treatment approach. It is important to identify the main mechanisms and take into account the factors that influence the frequency and intensity of symptoms.

Main causes / mechanisms (briefly)

• Disturbances in vascular tone leading to changes in blood flow in the head
• Increased sensitivity of nerve endings in the brain and surrounding tissues
• The influence of hormonal changes, especially in women
• Prolonged stress and overwork causing tension in the muscles of the head and neck
• Features of the nervous system associated with a hereditary predisposition

Risk factors

• Frequent stress and emotional strain
• Lack of sleep or an irregular rest schedule
• Excessive use of caffeine or alcohol
• Poor nutrition and dehydration
• Chronic diseases of internal organs
• A hereditary tendency to migraines and headaches
• Severe physical exertion without proper recovery

Reversible causes that should be ruled out

• Side effects of certain medications
• Vision problems or eye diseases
• Problems with the cervical spine and muscle tone
• The effects of acute infections or intoxications

The causes of headaches and migraines may overlap, so to accurately understand the important factors, a medical evaluation and, if necessary, additional examinations are required.

Diagnosis

The diagnosis of headaches and migraines is aimed at identifying possible causes and clarifying the characteristics of the symptoms. This process helps determine which examinations are needed and develop a plan for further action.

Approach to diagnosis

• Collecting a detailed medical history, including complaints and past illnesses
• Physical examination, including assessment of the nervous system and blood vessels
• Ordering basic tests to rule out acute and chronic conditions
• If necessary, performing additional examinations based on indications
• Interpreting the results and discussing next steps with the patient

Typical tests when indicated

Diagnosis may include:

• Magnetic resonance imaging (MRI) of the head
• Ultrasound examination of the neck and head vessels
• Electroencephalogram (EEG) if neurological disorders are suspected
• General laboratory tests to assess overall health
• Evaluation of the cervical spine

What to bring to the appointment

• Previous examinations and their results
• A list of medications currently being taken
• A symptom diary describing the frequency and intensity of headaches
• Notes about possible pain triggers or factors affecting the condition

Diagnosis of headaches and migraines requires a comprehensive approach and individual assessment, which makes it possible to choose an effective follow-up and treatment plan.

Treatment

The treatment of headaches and migraines is aimed at improving quality of life and reducing discomfort. The treatment plan is selected individually, taking into account the patient’s characteristics and current condition.

Goals of therapy

• Reducing the intensity and frequency of headaches
• Addressing possible causes and factors affecting symptoms
• Improving overall well-being and maintaining daily activity
• Preventing complications and exacerbations

Main treatment approaches

• May include medication methods aimed at symptom control
• Main directions include non-drug approaches such as relaxation and sleep routines
• Physiotherapy and rehabilitation measures when indicated
• Lifestyle adjustment based on individual risk factors
• Possible use of additional procedures if needed, subject to the doctor’s assessment

What the doctor does

• Selects and adjusts therapy according to the patient’s characteristics
• Assesses the presence of comorbidities and their impact on treatment
• Monitors the effectiveness of therapy and possible side effects
• Explains to the patient how and when to evaluate treatment results
• Coordinates interaction with other specialists in complex cases

What to expect: plan and follow-up

• Treatment effectiveness is assessed regularly, taking individual characteristics into account
• The treatment plan is adjusted if there is no adequate effect or if side effects occur
• Follow-up visits are necessary to monitor the condition and adapt therapeutic measures
• Monitoring helps maintain stable improvement and prevent relapses

To select an individualized plan, please book a consultation with Dr. Igor Stanislavovich Shkinder.

Prevention

Prevention plays an important role in reducing the risk of headaches and migraines. The preventive plan is selected individually, taking into account each patient’s specific characteristics.

Main measures for primary prevention

• Managing stress levels and regularly regulating emotional well-being
• Maintaining a proper sleep and rest schedule, avoiding chronic sleep deprivation
• Staying properly hydrated and following a balanced diet
• Reducing or eliminating caffeine and alcohol as advised
• Regular physical activity in line with your doctor’s recommendations
• Managing and treating associated chronic conditions

Screening and secondary prevention / regular monitoring

• Regular monitoring of blood pressure and metabolism as indicated
• Tracking treatment effectiveness and adjusting the plan if necessary
• Periodic consultations with a neurologist to assess changes in the condition
• Examinations as indicated to rule out reversible causes

Practical advice

• Keep a symptom diary to track possible triggers
• Discuss with your doctor whether medications should be adjusted if you have other medical conditions
• Avoid prolonged periods of tension and overexertion
• Make time for relaxation practices and regular breaks during work
• Pay attention to posture and the condition of the cervical spine

Preventive measures help reduce the impact of factors that trigger headaches and migraines; their selection always requires consultation with a doctor.

Important to Know

Headaches and migraines are a common problem that can significantly reduce quality of life. Treatment is aimed not only at relieving symptoms, but also at identifying possible causes and factors that influence the onset of pain. Early assessment helps determine the right treatment plan and reduce the risk of complications or progression. In some cases, ongoing monitoring is needed so that treatment can be adjusted based on changes in the patient’s condition. Important factors that can affect the course of headaches include stress, workload, sleep quality, and underlying medical conditions. Self-medication can make diagnosis more difficult, cause side effects, and delay the start of appropriate treatment.

• It is important to identify the causes and triggering factors, not just suppress the pain
• Early consultation helps choose an effective treatment approach and reduce risks
• Ongoing monitoring is necessary to adjust treatment and control symptoms
• Stress, workload, lack of sleep, and chronic illnesses affect the course of headaches
• Self-administration of medications can blur the clinical picture and delay diagnosis
• Our clinic provides comprehensive diagnostics and a treatment plan tailored to each patient’s individual features

Understanding the important aspects of headaches and migraines makes it possible to seek specialist help in time and receive care. Together with a doctor, you can develop a plan that will help control symptoms and improve quality of life. For detailed information and recommendations, we recommend reviewing our general page dedicated to headaches and migraines.

Self-help before the appointment: what you can and cannot do

Before your appointment for headaches and migraines, it is important to take safe measures so as not to worsen your condition and to keep the diagnosis accurate. If your symptoms worsen, seek medical help from Dr. Igor Stanislavovich Shkinder immediately.

What you can do before the appointment

• Note when and how the headaches started, the circumstances, and possible triggers
• Keep a symptom diary: pain intensity, time of day, what relieves or worsens the pain
• Bring a list of your current medications to the appointment, including dosages if you know them
• Measure and record your temperature, blood pressure, and pulse if you know how
• Rest and reduce physical activity until you consult a doctor
• Drink water to avoid dehydration, especially if you have frequent headaches
• Use simple relaxation methods and breathing exercises if they usually help you
• Try to maintain a regular sleep and rest schedule as much as possible

What you should not do before the appointment

• Do not stop or change any medications without consulting a doctor
• Do not start using a combination of new remedies or mix medications on your own
• Do not rely on unverified folk remedies for treating headaches
• Do not try to diagnose yourself or interpret test results on your own
• Do not ignore worsening pain or the appearance of new symptoms — contact a doctor
• Do not rely on self-treatment for recurrent or chronic headaches
• Do not delay seeking medical care if your condition worsens or unusual signs appear

If there are signs of an emergency, seek immediate help from Dr. Igor Stanislavovich Shkinder.

How I can help as a doctor with headaches and migraines

When you seek care for headaches and migraines, it is important to receive a comprehensive evaluation and support in order to understand the causes of your symptoms and choose the best course of action. During the consultation, I will help you understand the details of your condition, take into account all relevant factors, and determine the next steps to improve your quality of life. In a headache and migraine consultation, I can help you with the following:

• Review your symptoms and medical history to identify possible causes of your headaches
• Assess the severity of your symptoms and identify risk factors
• Perform an initial evaluation and, if necessary, order additional tests
• Review your current treatment plan and assess medication tolerability
• Develop a treatment and management plan taking into account the stages of evaluation and follow-up
• Consider associated conditions and the effect of current medications on treatment
• Provide recommendations on routine and lifestyle based on your individual indications
• Discuss criteria for evaluating treatment effectiveness and the timing of follow-up visits
• Adjust the treatment plan if the effect is insufficient or if side effects occur

My approach is based on a careful review of each case in order to choose a strategy that best matches your needs and health characteristics. This approach makes it possible not only to relieve current symptoms, but also to reduce the risk of complications or recurrent flare-ups.

What questions can you ask a doctor about headaches and migraines

At an appointment for headaches and migraines, you can discuss the following issues with Igor Stanislavovich Shkinder:

• Frequent and severe headaches that interfere with daily life
• Pain that worsens with physical activity or changes in nature
• Recurrent migraine attacks with other symptoms
• Sleep disturbances or fatigue related to headaches
• Lack of effect from previously prescribed treatment
• Questions about getting a second opinion and reviewing already completed examinations
• Particulars of recovery after a stroke or injury
• If you experience sudden weakness, speech problems, or loss of coordination, emergency care is needed — do not wait for a scheduled appointment

What questions can you ask the doctor?

1. What is happening to me, and what could it be?
2. Why did the headaches start right now?
3. How can I tell whether this is related to migraines rather than other causes?
4. What examinations are needed in my case specifically?
5. Which tests and investigations are truly necessary?
6. How should I prepare properly for the examination and the appointment?
7. What treatment options are available for headaches, and how do they differ?
8. Can headaches be completely cured, or is this a chronic condition?
9. What should I do if the prescribed treatment does not help?
10. Is it possible to manage without medications or surgery?
11. How long does treatment usually take, and how often are follow-up visits needed?
12. What signs show that the condition is improving or getting worse?
13. What should I do if my condition suddenly worsens or an exacerbation begins?

It is important to understand that the doctor will carefully review your situation, assess your symptoms and possible causes, and, if necessary, refer you for additional examinations or to other specialists.

If emergency symptoms appear, such as sudden severe pain, loss of coordination, or speech problems, seek emergency help immediately.

A consultation will help you understand your concerns and create a plan for further action to improve your condition.

How the consultation takes place

A consultation for headaches and migraines is a careful review of your symptoms, an assessment of the nervous system, and the development of a plan for next steps. The scope of examinations is determined individually and only when indicated, taking into account your symptoms and related factors. It is not always possible to get definitive answers during a single appointment, but you will receive an initial assessment and recommendations.

1. Clarifying your concerns and the purpose of the visit, discussing what is troubling you and how long the symptoms have been present
2. Taking a medical history, including possible risk factors and the impact of any coexisting conditions
3. Reviewing previous tests and treatment, with a recommendation to bring any available medical records and a list of medications you are taking
4. Performing an examination and any necessary simple tests to assess your condition, if indicated
5. Preliminary analysis of the situation — what may be causing the headaches and what is important to rule out
6. Discussing the need for additional investigations, which may include brain MRI, vascular ultrasound, EEG, laboratory tests, and other procedures as indicated
7. Developing a treatment plan and lifestyle recommendations without specifying particular medications
8. Arranging follow-up, setting the timing of the next visit, and defining criteria for return consultation

If you are seeking help for headaches for the first time, special attention during the consultation is given to clarifying the symptoms and identifying possible causes. If there has been no effect from previously prescribed treatment, the doctor will review the situation and adjust the management approach.

This approach makes it possible to move step by step toward improvement, minimizing risks and taking into account the individual characteristics of your health.

Preparing for Your Appointment

To make your headache and migraine consultation as effective as possible, it is important to prepare well. This will help establish a preliminary diagnosis more quickly and create a treatment plan.

• Bring a list of all current medications, including names and dosages, if you know them
• Bring the results of any previous examinations, scans, and tests, including MRI, vascular ultrasound, EEG, and laboratory test results
• Write down your main complaints: when the symptoms started, and what makes the pain worse or relieves it
• Do not stop taking any prescribed medications without consulting your doctor
• Come without makeup and do not use hair products on the day of your appointment (if applicable)
• If you have any doubts, уточните details of the preparation when booking by phone
• Do not change your treatment regimen on your own before the appointment
• If necessary, take your medications according to your usual schedule
• If instructed, come fasting: do not eat or drink for 8–12 hours (unless you were told otherwise; please confirm when booking)

If you have any questions about preparation, it is best to clarify them in advance with the reception desk so that your visit is as comfortable and productive as possible.

About the Doctor

Shkinder Igor Stanislavovich is a neurologist of the highest category with over 20 years of experience.

He frequently works with patients who suffer from various types of headaches and migraines, including cases with recurring symptoms and ineffective previous treatment.

In his practice, Igor Stanislavovich Shkinder pays special attention to differential diagnosis of the causes and to preventing flare-ups.

His approach is based on a careful analysis of each patient’s complaints and medical history.

During the consultation, you will receive a clear explanation of your condition and recommendations for next steps.

Why patients choose Dr. Igor Stanislavovich Shkinder

When seeking help for headaches and migraines, what matters is not just a diagnosis, but a comprehensive assessment of the situation and an individualized follow-up and treatment plan. Igor Stanislavovich Shkinder pays attention to every stage of therapy, taking into account possible comorbid conditions and the progression of symptoms. Patients appreciate this integrated approach, which goes beyond simply prescribing a medication and involves ongoing monitoring and adjustment of the treatment strategy.

• A clear treatment plan with specific steps: what is done now, what is being assessed, and when the next appointment is
• Tests and examinations only when indicated, with no unnecessary procedures, to minimize the burden
• Consideration of comorbidities and drug interactions to ensure safe treatment selection
• Monitoring of progress and prompt treatment adjustments if there is no effect or if side effects occur
• Review of existing examinations and test results to assess the full picture of health
• Explanation of the plan and medical terms in simple language so the patient understands what to do
• Emphasis on preventing flare-ups, which helps maintain stable condition
• Experience managing complex and chronic cases, which is important for recurrent and persistent headaches

This approach helps not only identify possible causes of headaches, but also reduce the risk of complications in the future. Patients receive comprehensive support and guidance at every stage of treatment and recovery.

Case Studies

Initial Consultation for Frequent Headaches

A middle-aged patient presented with complaints of regular headaches that interfered with work and rest. It was important to rule out serious neurological causes and identify possible triggers. A detailed clinical assessment of the symptoms was performed, the medical history was reviewed, and the necessary investigations were ordered as indicated. Over time, a noticeable reduction in the frequency and intensity of the headaches was observed, and quality of life improved. Ongoing follow-up and lifestyle adjustments helped maintain the result.

Treatment Adjustment After Lack of Effect

A young woman sought care after a long course of migraine medication that had not provided the expected relief. It was important to reconsider the treatment strategy and take tolerability and side effects into account. A detailed review of previous treatments and symptoms was carried out, and the approach was adjusted based on the clinical course and the patient’s specific features. At follow-up visits, gradual improvement and a reduction in the number of attacks were noted. Regular monitoring was arranged to adapt the therapy as needed.

Chronic Course with Comorbid Conditions

An elderly patient with a long history of headaches and associated chronic conditions came for a consultation. It was necessary to consider the impact of other illnesses and medication compatibility. A comprehensive assessment was performed, risk factors and drug interactions were analyzed. As a result of treatment, the patient’s condition stabilized and the headaches became less severe. A maintenance treatment plan and periodic monitoring were prescribed.

Symptom Flare-Up and Prevention Plan

A middle-aged woman presented with a sudden worsening of headaches in the context of stress and poor sleep. A prompt assessment and an action plan were needed to reduce the risk of complications. An examination was performed, conditions requiring urgent intervention were ruled out, and the treatment plan was adjusted. After several weeks of follow-up, her condition improved and the frequency of flare-ups decreased. An individualized prevention plan and recommendations regarding daily routine were developed.

Recurring Symptoms and Need for a Second Opinion

A young man came in with recurring headaches after an initially unclear diagnosis. It was important to provide an independent assessment and rule out any potentially missed causes. A detailed review of the complaints was completed, the medical history was taken, and several investigations were performed as indicated. The findings made it possible to clarify the cause and adjust the treatment. Over time, the severity of the symptoms decreased, and the patient remains under observation for monitoring.

How long does the consultation last?

A consultation usually lasts from 30 to 60 minutes. Please уточнять the exact time when booking.

How should I prepare for the appointment?

Write down your symptoms, how often they occur, possible triggers, and any questions you have for the doctor.

What should I bring to the appointment?

Bring any test results, scans, discharge summaries, and a list of your current medications with dosages.

Do I need to come on an empty stomach?

Usually no, unless otherwise specified when booking.

How many visits are usually required?

The number of visits depends on the complexity of the case and the chosen treatment approach.

When can I expect the first results of treatment?

The appearance of effects is individual and depends on the selected therapy.

What should I do if my condition worsens before the appointment?

If your symptoms worsen and you develop red-flag signs, seek urgent medical care without delay.

Can treatment be combined with my current medications?

Discuss all of your medications with the doctor. You should not change treatment on your own.

Can I have an online consultation?

Yes, an online consultation is available by prior appointment.

Can I come to the appointment with tests already done?

Yes, bring all available results for a more accurate assessment of your condition.

Do I need follow-up visits, and how often?

Follow-up visits are scheduled individually to monitor progress and adjust treatment.

Can I get a second opinion?

Yes, the doctor is ready to review your previous tests and prescribed treatment.

What should I do if symptoms return after improvement?

Contact your doctor for additional evaluation and adjustment of the treatment plan.

What tests are usually prescribed for headaches?

Tests are selected individually based on indications, and their number depends on the situation.

Can the consultation be combined with visits to other specialists?

Coordination with related specialists is discussed during the appointment for a comprehensive approach.

What affects the results of headache treatment?

Treatment outcomes are influenced by the cause of the headaches, accompanying conditions, and adherence to recommendations.

What should I do if previous treatment did not help?

During the consultation, your previous prescriptions will be reviewed and therapy adjusted if necessary.

Can I change the dosage or stop taking medications on my own?

It is not recommended to change dosages or stop medications without the doctor’s approval.

Should I keep a symptom diary?

Keeping a diary helps identify triggers and assess treatment effectiveness, so it is recommended.

What should I do if headaches interfere with work or study?

Discuss the situation with your doctor to choose the best treatment plan and support.