Create a pdf on headache?

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Finding Sources

Reading File

Finding Sources

Reading File

Finding Sources

Running Command

mkdir -p /home/daytona/workspace/headache-pdf && ls /home/daytona/workspace/headache-pdf/

Writing File

~/headache-pdf/build_headache_pdf.py

from reportlab.lib.pagesizes import A4
from reportlab.lib import colors
from reportlab.lib.units import cm
from reportlab.lib.styles import getSampleStyleSheet, ParagraphStyle
from reportlab.lib.enums import TA_LEFT, TA_CENTER, TA_JUSTIFY
from reportlab.platypus import (
    SimpleDocTemplate, Paragraph, Spacer, Table, TableStyle,
    HRFlowable, KeepTogether
)
from reportlab.platypus import PageBreak
from reportlab.lib.colors import HexColor

# ── colours ──────────────────────────────────────────────────────────────────
DARK_BLUE   = HexColor("#1B3A6B")
MID_BLUE    = HexColor("#2E6DA4")
LIGHT_BLUE  = HexColor("#D6E4F0")
ACCENT_RED  = HexColor("#C0392B")
ACCENT_GOLD = HexColor("#D4A017")
WHITE       = colors.white
LIGHT_GREY  = HexColor("#F4F6F9")
DARK_GREY   = HexColor("#2C3E50")
MED_GREY    = HexColor("#7F8C8D")

W, H = A4

# ── document ─────────────────────────────────────────────────────────────────
doc = SimpleDocTemplate(
    "/home/daytona/workspace/headache-pdf/Headache_Clinical_Overview.pdf",
    pagesize=A4,
    leftMargin=1.8*cm, rightMargin=1.8*cm,
    topMargin=2*cm, bottomMargin=2*cm,
    title="Headache – Clinical Overview",
    author="Orris Medical Library",
)

# ── styles ────────────────────────────────────────────────────────────────────
base = getSampleStyleSheet()

def S(name, **kw):
    s = ParagraphStyle(name, **kw)
    return s

TITLE_S = S("title_s", fontName="Helvetica-Bold", fontSize=26,
            textColor=WHITE, alignment=TA_CENTER, leading=32, spaceAfter=4)
SUBTITLE_S = S("subtitle_s", fontName="Helvetica", fontSize=13,
               textColor=LIGHT_BLUE, alignment=TA_CENTER, leading=18, spaceAfter=6)
META_S = S("meta_s", fontName="Helvetica-Oblique", fontSize=10,
           textColor=HexColor("#AED6F1"), alignment=TA_CENTER, leading=14)

H1 = S("h1", fontName="Helvetica-Bold", fontSize=14,
        textColor=WHITE, leading=18, spaceAfter=4, spaceBefore=4)
H2 = S("h2", fontName="Helvetica-Bold", fontSize=11,
        textColor=DARK_BLUE, leading=15, spaceAfter=3, spaceBefore=8)
H3 = S("h3", fontName="Helvetica-BoldOblique", fontSize=10,
        textColor=MID_BLUE, leading=14, spaceAfter=2, spaceBefore=5)
BODY = S("body", fontName="Helvetica", fontSize=9.5, leading=14,
          textColor=DARK_GREY, alignment=TA_JUSTIFY, spaceAfter=4)
BULLET = S("bullet", fontName="Helvetica", fontSize=9.5, leading=13,
            textColor=DARK_GREY, leftIndent=14, bulletIndent=4, spaceAfter=2)
SMALL = S("small", fontName="Helvetica", fontSize=8.5, leading=12,
           textColor=MED_GREY, spaceAfter=2)
SOURCE = S("source", fontName="Helvetica-Oblique", fontSize=8,
            textColor=MED_GREY, alignment=TA_CENTER, spaceAfter=0)
RED_FLAG_TITLE = S("rf_title", fontName="Helvetica-Bold", fontSize=10,
                    textColor=ACCENT_RED, leading=14, spaceAfter=2)

story = []

# ════════════════════════════════════════════════════════════════════════════
# PAGE 1 – Cover banner + Introduction
# ════════════════════════════════════════════════════════════════════════════

# Hero banner table
banner_data = [[
    Paragraph("HEADACHE", TITLE_S),
]]
banner = Table(banner_data, colWidths=[W - 3.6*cm])
banner.setStyle(TableStyle([
    ("BACKGROUND", (0,0), (-1,-1), DARK_BLUE),
    ("TOPPADDING", (0,0), (-1,-1), 22),
    ("BOTTOMPADDING", (0,0), (-1,-1), 8),
    ("LEFTPADDING", (0,0), (-1,-1), 12),
    ("RIGHTPADDING", (0,0), (-1,-1), 12),
    ("ROUNDEDCORNERS", [8], (0,0), (-1,-1)),
]))
story.append(banner)

sub_data = [[Paragraph("A Clinical Overview for Medical Students & Clinicians", SUBTITLE_S)]]
sub_table = Table(sub_data, colWidths=[W - 3.6*cm])
sub_table.setStyle(TableStyle([
    ("BACKGROUND", (0,0), (-1,-1), MID_BLUE),
    ("TOPPADDING", (0,0), (-1,-1), 6),
    ("BOTTOMPADDING", (0,0), (-1,-1), 6),
    ("LEFTPADDING", (0,0), (-1,-1), 12),
    ("RIGHTPADDING", (0,0), (-1,-1), 12),
]))
story.append(sub_table)
story.append(Paragraph("Sources: Adams & Victor's Neurology · Goldman-Cecil Medicine · Rosen's Emergency Medicine · Harrison's 22E · Goodman & Gilman's Pharmacology", SOURCE))
story.append(Spacer(1, 0.4*cm))

# ── Introduction ─────────────────────────────────────────────────────────────
def section_header(title, colour=DARK_BLUE):
    data = [[Paragraph(title, H1)]]
    t = Table(data, colWidths=[W - 3.6*cm])
    t.setStyle(TableStyle([
        ("BACKGROUND", (0,0), (-1,-1), colour),
        ("TOPPADDING", (0,0), (-1,-1), 5),
        ("BOTTOMPADDING", (0,0), (-1,-1), 5),
        ("LEFTPADDING", (0,0), (-1,-1), 8),
        ("RIGHTPADDING", (0,0), (-1,-1), 8),
        ("ROUNDEDCORNERS", [5], (0,0), (-1,-1)),
    ]))
    return t

story.append(section_header("1. INTRODUCTION & EPIDEMIOLOGY"))
story.append(Spacer(1, 0.2*cm))
story.append(Paragraph(
    "Headache is one of the most common complaints in clinical practice and a frequent reason for emergency department visits. "
    "The vast majority of patients presenting with headache have a benign primary cause such as tension-type headache or migraine. "
    "A minority have a secondary headache arising from an underlying medical or surgical condition requiring prompt diagnosis.",
    BODY))
story.append(Paragraph(
    "The clinician's primary goal is to distinguish primary headache (where head pain is the only identifiable disease) from "
    "<b>secondary headache</b> (caused by an underlying structural, vascular, or systemic condition). Headache is "
    "disproportionately represented in emergency medicine malpractice claims, largely because serious causes such as "
    "subarachnoid haemorrhage (SAH) are missed on first presentation in over 25% of cases.",
    BODY))
story.append(Spacer(1, 0.3*cm))

# ── Classification ────────────────────────────────────────────────────────────
story.append(section_header("2. CLASSIFICATION (IHS)"))
story.append(Spacer(1, 0.2*cm))

class_data = [
    ["Category", "Types"],
    ["Primary Headaches\n(no underlying cause)", "• Migraine (with/without aura)\n• Tension-type headache\n• Cluster headache & TACs\n• Other primary headaches"],
    ["Secondary Headaches\n(underlying disease)", "• SAH / Intracranial haemorrhage\n• Meningitis / Encephalitis\n• Raised intracranial pressure\n• Cervical artery dissection\n• CO poisoning · Temporal arteritis\n• Idiopathic intracranial hypertension"],
]
ct = Table(class_data, colWidths=[5.5*cm, 10.5*cm])
ct.setStyle(TableStyle([
    ("BACKGROUND", (0,0), (-1,0), DARK_BLUE),
    ("TEXTCOLOR", (0,0), (-1,0), WHITE),
    ("FONTNAME", (0,0), (-1,0), "Helvetica-Bold"),
    ("FONTSIZE", (0,0), (-1,0), 10),
    ("BACKGROUND", (0,1), (-1,1), LIGHT_BLUE),
    ("BACKGROUND", (0,2), (-1,2), LIGHT_GREY),
    ("FONTNAME", (0,1), (0,-1), "Helvetica-Bold"),
    ("FONTSIZE", (0,1), (-1,-1), 9),
    ("VALIGN", (0,0), (-1,-1), "MIDDLE"),
    ("TOPPADDING", (0,0), (-1,-1), 5),
    ("BOTTOMPADDING", (0,0), (-1,-1), 5),
    ("LEFTPADDING", (0,0), (-1,-1), 7),
    ("RIGHTPADDING", (0,0), (-1,-1), 7),
    ("GRID", (0,0), (-1,-1), 0.5, MID_BLUE),
    ("ROUNDEDCORNERS", [4], (0,0), (-1,-1)),
]))
story.append(ct)
story.append(Spacer(1, 0.4*cm))

# ── RED FLAGS ─────────────────────────────────────────────────────────────────
story.append(KeepTogether([
    section_header("3. RED FLAGS ('SNOOP4' MNEMONIC)", colour=ACCENT_RED),
    Spacer(1, 0.2*cm),
    Paragraph(
        "These features should prompt urgent investigation for a secondary cause:",
        BODY),
]))

snoop_data = [
    ["Letter", "Meaning", "Concern"],
    ["S", "Systemic symptoms / disease", "Fever, weight loss, HIV, cancer"],
    ["N", "Neurological signs / symptoms", "Focal deficits, altered consciousness"],
    ["O", "Onset sudden / thunderclap", "SAH until proven otherwise"],
    ["O", "Older age (>50 yrs) new headache", "Temporal arteritis, malignancy"],
    ["P", "Pattern change", "New or progressive in known headache patient"],
    ["P", "Postural component", "IIH (worse supine) or low CSF pressure"],
    ["P", "Precipitated by Valsalva", "Mass lesion, AVM, aneurysm"],
    ["P", "Papilloedema / Pregnancy", "Raised ICP, pre-eclampsia"],
]
st = Table(snoop_data, colWidths=[1.2*cm, 5.8*cm, 9*cm])
st.setStyle(TableStyle([
    ("BACKGROUND", (0,0), (-1,0), ACCENT_RED),
    ("TEXTCOLOR", (0,0), (-1,0), WHITE),
    ("FONTNAME", (0,0), (-1,0), "Helvetica-Bold"),
    ("FONTSIZE", (0,0), (-1,-1), 9),
    ("FONTNAME", (0,1), (0,-1), "Helvetica-Bold"),
    ("TEXTCOLOR", (0,1), (0,-1), ACCENT_RED),
    ("ROWBACKGROUNDS", (0,1), (-1,-1), [WHITE, LIGHT_GREY]),
    ("TOPPADDING", (0,0), (-1,-1), 4),
    ("BOTTOMPADDING", (0,0), (-1,-1), 4),
    ("LEFTPADDING", (0,0), (-1,-1), 6),
    ("RIGHTPADDING", (0,0), (-1,-1), 6),
    ("GRID", (0,0), (-1,-1), 0.4, MED_GREY),
]))
story.append(st)

story.append(PageBreak())

# ════════════════════════════════════════════════════════════════════════════
# PAGE 2 – Primary Headaches
# ════════════════════════════════════════════════════════════════════════════
story.append(section_header("4. PRIMARY HEADACHES"))
story.append(Spacer(1, 0.25*cm))

# ── 4a Migraine ──────────────────────────────────────────────────────────────
story.append(Paragraph("4a. Migraine", H2))
story.append(Paragraph(
    "<b>Epidemiology:</b> Affects 10–20% of the population; peak incidence earlier in boys than girls but overall female predominance after puberty.",
    BODY))
story.append(Paragraph(
    "<b>Types:</b> Migraine <i>without</i> aura (common migraine) and migraine <i>with</i> aura (classic migraine). "
    "Aura may begin up to 24 hours before pain onset and often includes photophobia, hyperacusis, polyuria, and mood disturbance.",
    BODY))
story.append(Paragraph(
    "<b>Pathogenesis:</b> Complex neural and vascular interaction. Serotonin (5-HT) is a key mediator — plasma/platelet 5-HT levels "
    "vary across migraine phases, and urinary 5-HT metabolites are elevated during attacks. The trigeminovascular system mediates most of the pain.",
    BODY))

mig_data = [
    ["Feature", "Details"],
    ["Site", "Unilateral (may be bilateral); frontotemporal"],
    ["Character", "Pulsating / throbbing"],
    ["Severity", "Moderate to severe; disabling"],
    ["Duration", "4–72 hours"],
    ["Associated", "Nausea, vomiting, photophobia, phonophobia"],
    ["Aggravated by", "Routine physical activity"],
    ["Behaviour", "Patient prefers to rest / lie still in dark room"],
]
mt = Table(mig_data, colWidths=[4.5*cm, 11.5*cm])
mt.setStyle(TableStyle([
    ("BACKGROUND", (0,0), (-1,0), MID_BLUE),
    ("TEXTCOLOR", (0,0), (-1,0), WHITE),
    ("FONTNAME", (0,0), (-1,0), "Helvetica-Bold"),
    ("FONTSIZE", (0,0), (-1,-1), 9),
    ("FONTNAME", (0,1), (0,-1), "Helvetica-Bold"),
    ("ROWBACKGROUNDS", (0,1), (-1,-1), [WHITE, LIGHT_BLUE]),
    ("TOPPADDING", (0,0), (-1,-1), 4),
    ("BOTTOMPADDING", (0,0), (-1,-1), 4),
    ("LEFTPADDING", (0,0), (-1,-1), 6),
    ("RIGHTPADDING", (0,0), (-1,-1), 6),
    ("GRID", (0,0), (-1,-1), 0.4, MED_GREY),
]))
story.append(mt)
story.append(Spacer(1, 0.15*cm))

story.append(Paragraph("<b>Treatment:</b>", H3))
story.append(Paragraph(
    "<b>Abortive (acute):</b> NSAIDs (ibuprofen/naproxen) for mild-moderate attacks. "
    "Triptans (5-HT1B/1D agonists) — sumatriptan, zolmitriptan, rizatriptan — for moderate-severe attacks; "
    "start as early as possible. IV metoclopramide or prochlorperazine (dopamine antagonists) for parenteral management in ED. "
    "Opioids are NOT recommended for primary headaches.",
    BODY))
story.append(Paragraph(
    "<b>Prophylaxis (preventive):</b> Indicated when attacks are frequent or disabling. "
    "Options include β-blockers (propranolol, metoprolol), tricyclic antidepressants (amitriptyline), "
    "anticonvulsants (valproate, topiramate), and CGRP monoclonal antibodies (newer agents).",
    BODY))
story.append(Spacer(1, 0.25*cm))

# ── 4b Tension-Type ───────────────────────────────────────────────────────────
story.append(Paragraph("4b. Tension-Type Headache (TTH)", H2))
story.append(Paragraph(
    "The most common primary headache disorder. The term 'tension-type' reflects that actual muscle tension may not always be present.",
    BODY))

tth_data = [
    ["Feature", "Details"],
    ["Site", "Bilateral"],
    ["Character", "Pressing / tightening ('band-like'); non-pulsating"],
    ["Severity", "Mild to moderate; not disabling"],
    ["Duration", "30 min – 7 days"],
    ["Associated", "May have photophobia OR phonophobia (not both); no nausea/vomiting"],
    ["Aggravated by", "Not worsened by routine activity"],
    ["Behaviour", "Patient can continue daily activities"],
]
tt = Table(tth_data, colWidths=[4.5*cm, 11.5*cm])
tt.setStyle(TableStyle([
    ("BACKGROUND", (0,0), (-1,0), MID_BLUE),
    ("TEXTCOLOR", (0,0), (-1,0), WHITE),
    ("FONTNAME", (0,0), (-1,0), "Helvetica-Bold"),
    ("FONTSIZE", (0,0), (-1,-1), 9),
    ("FONTNAME", (0,1), (0,-1), "Helvetica-Bold"),
    ("ROWBACKGROUNDS", (0,1), (-1,-1), [WHITE, LIGHT_BLUE]),
    ("TOPPADDING", (0,0), (-1,-1), 4),
    ("BOTTOMPADDING", (0,0), (-1,-1), 4),
    ("LEFTPADDING", (0,0), (-1,-1), 6),
    ("RIGHTPADDING", (0,0), (-1,-1), 6),
    ("GRID", (0,0), (-1,-1), 0.4, MED_GREY),
]))
story.append(tt)
story.append(Paragraph(
    "<b>Treatment:</b> Simple analgesics (paracetamol, NSAIDs). Preventive: amitriptyline. "
    "Avoid medication overuse (>10–15 days/month leads to medication-overuse headache).",
    BODY))
story.append(Spacer(1, 0.25*cm))

# ── 4c Cluster ────────────────────────────────────────────────────────────────
story.append(Paragraph("4c. Cluster Headache & Trigeminal Autonomic Cephalalgias (TACs)", H2))
story.append(Paragraph(
    "Cluster headache is the most common TAC. It predominantly affects men (M:F = 3–7:1), "
    "onset typically 20–30 years of age. Attacks often precipitated by alcohol, histamine, or nitroglycerin.",
    BODY))

cl_data = [
    ["Feature", "Cluster Headache", "Paroxysmal Hemicrania", "SUNCT"],
    ["Sex (F:M)", "1 : 3–7", "2 : 1", "1 : 2"],
    ["Site", "Orbital/temporal (unilateral)", "Periorbital/temporal", "Orbital/temporal"],
    ["Character", "Boring / stabbing, excruciating", "Severe", "Stabbing"],
    ["Duration", "15–180 min", "2–30 min", "5–240 sec"],
    ["Frequency", "1–8 per day", "Up to 40/day", "3–200/day"],
    ["Autonomic features", "Lacrimation, conjunctival injection,\nptosis, miosis, rhinorrhoea", "Similar", "Conjunctival injection + tearing"],
    ["Behaviour", "Paces; cannot rest (unlike migraine)", "—", "—"],
    ["Acute Rx", "O₂ 100%, sumatriptan SC/nasal,\nDHE nasal spray", "None specific", "None specific"],
    ["Preventive Rx", "Verapamil, lithium, corticosteroids,\ngalcanezumab", "Indomethacin +++", "Lamotrigine, gabapentin"],
]
clt = Table(cl_data, colWidths=[3.8*cm, 4.8*cm, 4*cm, 3.4*cm])
clt.setStyle(TableStyle([
    ("BACKGROUND", (0,0), (-1,0), DARK_BLUE),
    ("TEXTCOLOR", (0,0), (-1,0), WHITE),
    ("FONTNAME", (0,0), (-1,0), "Helvetica-Bold"),
    ("FONTSIZE", (0,0), (-1,-1), 8.5),
    ("FONTNAME", (0,1), (0,-1), "Helvetica-Bold"),
    ("ROWBACKGROUNDS", (0,1), (-1,-1), [WHITE, LIGHT_BLUE]),
    ("TOPPADDING", (0,0), (-1,-1), 4),
    ("BOTTOMPADDING", (0,0), (-1,-1), 4),
    ("LEFTPADDING", (0,0), (-1,-1), 5),
    ("RIGHTPADDING", (0,0), (-1,-1), 5),
    ("VALIGN", (0,0), (-1,-1), "TOP"),
    ("GRID", (0,0), (-1,-1), 0.4, MED_GREY),
]))
story.append(clt)

story.append(PageBreak())

# ════════════════════════════════════════════════════════════════════════════
# PAGE 3 – Secondary Headaches, Investigations, Management
# ════════════════════════════════════════════════════════════════════════════
story.append(section_header("5. SECONDARY HEADACHES — KEY CAUSES"))
story.append(Spacer(1, 0.2*cm))

sec_data = [
    ["Condition", "Hallmark Features", "Investigation"],
    ["Subarachnoid\nHaemorrhage (SAH)", "Thunderclap headache — 'worst of my life'\n>25% missed on first presentation", "CT head → LP (xanthochromia) → CTA"],
    ["Bacterial Meningitis", "Severe headache + fever + neck stiffness\n± Kernig/Brudzinski signs, purpuric rash", "CT (if indicated) → LP; IV antibiotics BEFORE LP if delay"],
    ["Idiopathic Intracranial\nHypertension (IIH)", "Obese young woman; bilateral headache\nworse supine, papilloedema, VI nerve palsy", "MRI/MRV brain; LP (opening pressure >25 cmH₂O)"],
    ["Temporal (Giant Cell)\nArteritis", "Age >50, new headache, temporal artery\ntenderness, jaw claudication, raised ESR/CRP", "ESR, CRP; temporal artery biopsy"],
    ["Cervical Artery\nDissection", "Neck pain + headache; Horner syndrome\n± stroke symptoms", "MRI/MRA; CTA neck"],
    ["CO Poisoning", "Multiple household members affected\nHeadache, nausea, confusion", "COHb level; remove from source; 100% O₂"],
    ["Intracranial Mass", "Progressive headache, worse in morning\n± focal deficits, seizures, papilloedema", "MRI brain with contrast"],
]
secc = Table(sec_data, colWidths=[4*cm, 6.5*cm, 5.5*cm])
secc.setStyle(TableStyle([
    ("BACKGROUND", (0,0), (-1,0), DARK_BLUE),
    ("TEXTCOLOR", (0,0), (-1,0), WHITE),
    ("FONTNAME", (0,0), (-1,0), "Helvetica-Bold"),
    ("FONTSIZE", (0,0), (-1,-1), 8.5),
    ("FONTNAME", (0,1), (0,-1), "Helvetica-Bold"),
    ("ROWBACKGROUNDS", (0,1), (-1,-1), [WHITE, LIGHT_GREY]),
    ("TOPPADDING", (0,0), (-1,-1), 5),
    ("BOTTOMPADDING", (0,0), (-1,-1), 5),
    ("LEFTPADDING", (0,0), (-1,-1), 6),
    ("RIGHTPADDING", (0,0), (-1,-1), 6),
    ("VALIGN", (0,0), (-1,-1), "TOP"),
    ("GRID", (0,0), (-1,-1), 0.4, MED_GREY),
]))
story.append(secc)
story.append(Spacer(1, 0.35*cm))

# ── Investigations ────────────────────────────────────────────────────────────
story.append(section_header("6. INVESTIGATIONS"))
story.append(Spacer(1, 0.2*cm))
story.append(Paragraph(
    "<b>Most patients with headache do not require neuroimaging.</b> Investigations are tailored to "
    "specific clinical concerns identified by history and examination.",
    BODY))

inv_data = [
    ["Investigation", "Indication"],
    ["CT Head (non-contrast)", "Thunderclap / suspected SAH, ICH, or acute emergency"],
    ["LP (Lumbar Puncture)", "Normal CT but suspected SAH (xanthochromia ≥12 h), meningitis"],
    ["CT/MR Angiography", "Suspected aneurysm, cervical artery dissection"],
    ["MRI Brain ± contrast", "Suspected mass, IIH, cavernous sinus, posterior fossa lesion"],
    ["MR Venography (MRV)", "Cerebral venous sinus thrombosis, IIH"],
    ["Blood tests (ESR, CRP, CBC)", "Temporal arteritis, systemic illness, CO poisoning"],
    ["Fundoscopy", "Mandatory in all — papilloedema = raised ICP until disproven"],
]
invt = Table(inv_data, colWidths=[5*cm, 11*cm])
invt.setStyle(TableStyle([
    ("BACKGROUND", (0,0), (-1,0), MID_BLUE),
    ("TEXTCOLOR", (0,0), (-1,0), WHITE),
    ("FONTNAME", (0,0), (-1,0), "Helvetica-Bold"),
    ("FONTSIZE", (0,0), (-1,-1), 9),
    ("FONTNAME", (0,1), (0,-1), "Helvetica-Bold"),
    ("ROWBACKGROUNDS", (0,1), (-1,-1), [WHITE, LIGHT_BLUE]),
    ("TOPPADDING", (0,0), (-1,-1), 4),
    ("BOTTOMPADDING", (0,0), (-1,-1), 4),
    ("LEFTPADDING", (0,0), (-1,-1), 6),
    ("RIGHTPADDING", (0,0), (-1,-1), 6),
    ("GRID", (0,0), (-1,-1), 0.4, MED_GREY),
]))
story.append(invt)
story.append(Spacer(1, 0.35*cm))

# ── Management Summary ────────────────────────────────────────────────────────
story.append(section_header("7. MANAGEMENT SUMMARY"))
story.append(Spacer(1, 0.2*cm))

story.append(Paragraph("Acute / Abortive Therapy:", H3))
mgmt_data = [
    ["Headache Type", "First-line Acute Rx", "Parenteral (ED) Option"],
    ["Tension-type", "Paracetamol or NSAID", "Ketorolac IV"],
    ["Migraine (mild-mod)", "NSAID ± antiemetic", "Metoclopramide IV (also treats nausea)\nProchlorperazine IV (2nd line)"],
    ["Migraine (mod-severe)", "Triptan (e.g. sumatriptan 50 mg PO\nor 6 mg SC) ± NSAID", "IV metoclopramide or prochlorperazine;\nTriptan SC if available"],
    ["Cluster headache", "100% O₂ via non-rebreather 15 L/min\n+ sumatriptan 6 mg SC", "DHE nasal spray; zolmitriptan nasal"],
    ["Secondary (SAH etc)", "Treat underlying cause urgently", "Neurosurgical/ICU referral"],
]
mgt = Table(mgmt_data, colWidths=[4*cm, 6*cm, 6*cm])
mgt.setStyle(TableStyle([
    ("BACKGROUND", (0,0), (-1,0), DARK_BLUE),
    ("TEXTCOLOR", (0,0), (-1,0), WHITE),
    ("FONTNAME", (0,0), (-1,0), "Helvetica-Bold"),
    ("FONTSIZE", (0,0), (-1,-1), 8.5),
    ("FONTNAME", (0,1), (0,-1), "Helvetica-Bold"),
    ("ROWBACKGROUNDS", (0,1), (-1,-1), [WHITE, LIGHT_GREY]),
    ("TOPPADDING", (0,0), (-1,-1), 5),
    ("BOTTOMPADDING", (0,0), (-1,-1), 5),
    ("LEFTPADDING", (0,0), (-1,-1), 5),
    ("RIGHTPADDING", (0,0), (-1,-1), 5),
    ("VALIGN", (0,0), (-1,-1), "TOP"),
    ("GRID", (0,0), (-1,-1), 0.4, MED_GREY),
]))
story.append(mgt)
story.append(Spacer(1, 0.25*cm))

story.append(Paragraph("Preventive Therapy (Migraine):", H3))
prev_data = [
    ["Drug Class", "Examples", "Notes"],
    ["β-Blockers", "Propranolol, metoprolol", "First-line; avoid in asthma"],
    ["Tricyclic antidepressants", "Amitriptyline 10–75 mg nocte", "Also for TTH prevention"],
    ["Anticonvulsants", "Valproate, topiramate", "Valproate: avoid in pregnancy"],
    ["CGRP mAbs", "Erenumab, fremanezumab", "Newer agents; SC monthly"],
    ["Calcium channel blockers", "Verapamil", "First choice for cluster headache prevention"],
]
prevt = Table(prev_data, colWidths=[5*cm, 5.5*cm, 5.5*cm])
prevt.setStyle(TableStyle([
    ("BACKGROUND", (0,0), (-1,0), MID_BLUE),
    ("TEXTCOLOR", (0,0), (-1,0), WHITE),
    ("FONTNAME", (0,0), (-1,0), "Helvetica-Bold"),
    ("FONTSIZE", (0,0), (-1,-1), 9),
    ("FONTNAME", (0,1), (0,-1), "Helvetica-Bold"),
    ("ROWBACKGROUNDS", (0,1), (-1,-1), [WHITE, LIGHT_BLUE]),
    ("TOPPADDING", (0,0), (-1,-1), 4),
    ("BOTTOMPADDING", (0,0), (-1,-1), 4),
    ("LEFTPADDING", (0,0), (-1,-1), 6),
    ("RIGHTPADDING", (0,0), (-1,-1), 6),
    ("GRID", (0,0), (-1,-1), 0.4, MED_GREY),
]))
story.append(prevt)
story.append(Spacer(1, 0.4*cm))

# ── Key Points Box ───────────────────────────────────────────────────────────
kp_data = [[
    Paragraph(
        "<b>KEY POINTS</b><br/>"
        "• Thunderclap headache = SAH until proven otherwise — CT + LP if CT negative.<br/>"
        "• Opioids are NOT indicated for primary headache disorders.<br/>"
        "• Fundoscopy is mandatory — papilloedema indicates raised ICP.<br/>"
        "• Cluster headache patients pace; migraine patients lie still in the dark.<br/>"
        "• Paroxysmal hemicrania &amp; hemicrania continua respond dramatically to indomethacin (diagnostic).<br/>"
        "• Medication-overuse headache occurs with analgesic use &gt;10–15 days/month — wean the offending drug.",
        S("kp", fontName="Helvetica", fontSize=9, leading=14, textColor=DARK_BLUE))
]]
kpt = Table(kp_data, colWidths=[W - 3.6*cm])
kpt.setStyle(TableStyle([
    ("BACKGROUND", (0,0), (-1,-1), LIGHT_BLUE),
    ("TOPPADDING", (0,0), (-1,-1), 8),
    ("BOTTOMPADDING", (0,0), (-1,-1), 8),
    ("LEFTPADDING", (0,0), (-1,-1), 10),
    ("RIGHTPADDING", (0,0), (-1,-1), 10),
    ("BOX", (0,0), (-1,-1), 1.5, MID_BLUE),
    ("ROUNDEDCORNERS", [6], (0,0), (-1,-1)),
]))
story.append(kpt)
story.append(Spacer(1, 0.3*cm))

# ── Footer ───────────────────────────────────────────────────────────────────
story.append(HRFlowable(width="100%", thickness=0.5, color=MID_BLUE, spaceAfter=4))
story.append(Paragraph(
    "Sources: Adams &amp; Victor's Principles of Neurology 12e | Goldman-Cecil Medicine International Ed. | "
    "Rosen's Emergency Medicine | Harrison's Principles of Internal Medicine 22E | "
    "Goodman &amp; Gilman's Pharmacological Basis of Therapeutics | Frameworks for Internal Medicine",
    SOURCE))

# ── Build ─────────────────────────────────────────────────────────────────────
doc.build(story)
print("PDF built successfully.")

Running Command

cd /home/daytona/workspace/headache-pdf && python build_headache_pdf.py 2>&1

Running Command

python3 -c "import reportlab; print(reportlab.Version)"

Running Command

cd /home/daytona/workspace/headache-pdf && sed -i '/ROUNDEDCORNERS/d' build_headache_pdf.py && python build_headache_pdf.py 2>&1

Running Command

python3 -c " import re with open('/home/daytona/workspace/headache-pdf/build_headache_pdf.py','r') as f: content = f.read() content2 = re.sub(r'\s*\(\"ROUNDEDCORNERS\".*?\),\n', '\n', content) with open('/home/daytona/workspace/headache-pdf/build_headache_pdf.py','w') as f: f.write(content2) print('done') "

Running Command

cd /home/daytona/workspace/headache-pdf && python build_headache_pdf.py 2>&1

Running Command

ls -lh /home/daytona/workspace/headache-pdf/Headache_Clinical_Overview.pdf

Your PDF is ready for download:

Headache Clinical Overview

PDF Document · PDF

Here is what the 3-page PDF covers, all sourced from authoritative medical textbooks (Adams & Victor's Neurology, Goldman-Cecil Medicine, Rosen's Emergency Medicine, Harrison's 22E, Goodman & Gilman's Pharmacology):

Page 1

Introduction & Epidemiology - why headache is high-stakes clinically
IHS Classification table (Primary vs Secondary headaches)
SNOOP4 Red Flags table with colour-coded urgency

Page 2 - Primary Headaches

Migraine - features, pathogenesis (5-HT hypothesis), acute treatment (triptans, NSAIDs, IV metoclopramide) and prophylaxis
Tension-type headache - bilateral pressing character, management, warning about medication overuse
Cluster Headache & TACs - comparison table of Cluster vs Paroxysmal Hemicrania vs SUNCT (sex, duration, frequency, autonomic features, treatment)

Page 3

Secondary Headaches key causes table (SAH, Meningitis, IIH, Temporal Arteritis, CO poisoning, Mass Lesion) with hallmark features and investigations
Investigations guide - when to image, when to do LP
Management Summary - acute therapy per headache type + preventive drug classes
Key Points Box with high-yield clinical pearls

What is cancer?

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Here is a comprehensive explanation of cancer drawn from authoritative medical textbooks.

What is Cancer?

A neoplasm (tumor) is any abnormal new growth of tissue. Neoplasms may be benign or malignant. The term "cancer" specifically refers to malignant tumors - those that invade surrounding tissues and can spread to distant sites in the body. Cancer can arise in virtually any organ or tissue. - Harper's Illustrated Biochemistry, 32nd Ed.

Benign vs. Malignant Tumors

Feature	Benign Tumor	Malignant Tumor (Cancer)
Growth	Slow, controlled	Rapid, uncontrolled
Borders	Well-defined capsule	Irregular, invasive
Invasion	Does NOT invade locally	Invades adjacent tissues
Metastasis	Does NOT spread	Spreads to distant sites
Cell appearance	Near-normal (differentiated)	Abnormal (poorly differentiated)
Outcome	Usually harmless	Can be life-threatening

The Hallmarks of Cancer (Hanahan & Weinberg)

Cancer cells acquire specific biological capabilities that distinguish them from normal cells. These are the established and updated Hallmarks of Cancer:

Major biological features of cancer cells - Harper's Illustrated Biochemistry

Original 6 Hallmarks (2000):

Sustained proliferative signaling - self-sufficiency in growth signals
Evasion of tumor suppressors - insensitivity to anti-growth signals
Invasion and metastasis - ability to invade locally and spread distantly
Replicative immortality - unlimited replicative potential (telomerase activation)
Angiogenesis - induction of new blood vessel formation to feed the tumor
Resistance to apoptosis - ability to evade programmed cell death

Added in 2011:

Metabolic reprogramming (Warburg effect - aerobic glycolysis)
Genomic instability
Tumor-promoting inflammation
Immune evasion

- Murray & Nadel's Textbook of Respiratory Medicine

Genetic Basis of Cancer

Nonlethal genetic damage is the initiating event in carcinogenesis. Cancer originates from a single abnormal cell (clonal origin) that accumulates multiple genetic mutations over time - a process that can take years to decades. - Harper's Illustrated Biochemistry

Key categories of genes involved:

Gene Type	Normal Role	Effect of Mutation
Proto-oncogenes	Promote controlled cell growth	Become oncogenes - cause uncontrolled proliferation (gain-of-function)
Tumor suppressor genes	Inhibit cell division; induce apoptosis	Inactivated - "brakes" are lost (loss-of-function). e.g. TP53, RB1
DNA repair genes	Fix DNA errors	Mutations accumulate unchecked
Apoptosis-regulating genes	Control cell death	Cells become immortal

Driver mutations are the causative mutations that transform normal cells into cancer cells. Passenger mutations are additional mutations that accumulate but do not directly drive cancer progression.

Types of Cancer (by Cell of Origin)

Category	Origin	Examples
Carcinoma	Epithelial cells	Lung, breast, colon, prostate cancer (~85% of all cancers)
Sarcoma	Connective tissue (bone, muscle, fat)	Osteosarcoma, liposarcoma
Lymphoma	Lymphoid tissue	Hodgkin lymphoma, non-Hodgkin lymphoma
Leukaemia	Bone marrow / blood cells	AML, CLL, CML, ALL
Glioma	Glial cells of brain	Glioblastoma multiforme
Melanoma	Melanocytes (skin)	Cutaneous melanoma

Causes of Cancer (Carcinogens)

Genetic damage can arise from three broad sources:

Replication errors (R) - spontaneous errors in DNA copying; rate ~10⁻⁷ to 10⁻⁶ per cell per generation; higher in rapidly dividing tissues
Environmental carcinogens (E):
- Radiation - UV rays (skin cancer), X-rays and gamma rays (induce ROS and direct DNA strand breaks)
- Chemical carcinogens - polycyclic aromatic hydrocarbons (PAHs) in tobacco smoke cause DNA adducts → lung cancer; reactive metabolites cause mutations in TP53 and DNA repair genes
- Oncogenic viruses - introduce novel genes or modulate host growth-regulatory genes (e.g. HPV → cervical cancer; HBV/HCV → hepatocellular carcinoma; EBV → Burkitt lymphoma)
Hereditary mutations (H) - germline mutations in tumor suppressor genes (e.g. BRCA1/2 in breast/ovarian cancer; APC in familial adenomatous polyposis)

- Harper's Illustrated Biochemistry, Murray & Nadel's Respiratory Medicine

Tumor Microenvironment (TME)

Cancer is not just about the tumor cell itself. The tumor microenvironment - comprising surrounding stromal cells, immune cells, vasculature, and extracellular matrix - plays a significant role in tumor formation, progression, and resistance to therapy. Factors such as local hypoxia, paracrine signals, and pro-inflammatory mediators all contribute to the malignant phenotype. - Harper's Illustrated Biochemistry

Metastasis

Metastasis (spread to distant organs) is the main cause of cancer-related death. The process involves:

Local invasion of surrounding tissue (degradation of ECM by proteases)
Intravasation (entry into blood/lymphatic vessels)
Survival in circulation
Extravasation at a distant site
Colonization and growth at the new site

This is facilitated by Epithelial-Mesenchymal Transition (EMT), in which epithelial cancer cells acquire mesenchymal properties (motility, invasiveness).

Key Summary

Cancer = a clonal disease of uncontrolled cell proliferation driven by accumulated genetic mutations in proto-oncogenes, tumor suppressor genes, DNA repair genes, and apoptosis-regulating genes, resulting in a cell that grows without restraint, evades death, recruits blood vessels, invades locally, and spreads to distant organs.

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