<prompt> A 33-year-old woman experiences visions of flashing lights followed by throbbing left-sided temporal pain and nausea. The most likely diagnosis is:Tension headacheTransient ischemic attackCranial aeritisMigraine headache  <response>: The typical migraine attack consists of a visual aura with flashes, scintillating scotomata field loss, or foification spectra followed by a throbbing unilateral temporal headache. There may be associated vestibular, GI, or neurological symptoms. Attacks are often precipitated by stress, fatigue, or foods that contain tyramine eg, cheese, yogu, nuts or phenylethylamine wine, chocolate. Symptoms peak within an hour of onset and persist for hours to days. A positive family history is found in as many as 50 of cases. Tension headaches are more often bilateral and described as band-like or vise-like and are not usually associated with visual auras. TIAs more typically present as a transient monocular blindness without aura or headache. Cranial aeritis may present as painless loss of vision without aura. Meningoencephalitis is associated with nuchal rigidity and diffuse headache but not with visual auras. Acute treatment of migraine headache consists of ergotamine tarate, antiemetics, and analgesics. Prophylactic medications such as propranolol, dipyridamole, and methysergide are ineffective for acute attacks. Avoidance of known precipitants and control of stress are also impoant in prevention. Ref: Ropper A.H., Samuels M.A. 2009. Chapter 10. Headache and Other Craniofacial Pains. In A.H. Ropper, M.A. Samuels Eds, Adams and Victors Principles of Neurology, 9e. 