Causes
Thunderclap headache
SAH, pituitary apoplexy, haemorrhage into mass lesion or vascular malformation, posterior fossa mass lesion
CO poisoning
100% O2 therapy via a close-fitting mask
Normal CT scan excludes SAH -True or False
False
Examples of primary Headache
Tension ,Migraine , Cluster , Trigeminal neuralgia etc
Sharp, stabbing unilateral pain around the orbit, or temporal area (often with lacrimation)
Cluster Headache
Most common type of headache
Primary-Tension type
CVST
Heparin should be commenced to reduce the risk of clot extension
The most useful laboratory test in GCA
ESR
Examples of Secondary Headache
Intracranial vascular disorder , Intracranial non vascular disorder, Extracranial pathology
Frequent use of analgesic medications (paracetamol, codeine and NSAID’s)
Medication overuse headache /Rebound headache
Headache with fever, neck stiffness, or reduced level of consciousness
Meningitis, encephalitis, cerebral vasculitis
Temporal arteritis
Prednisolone 1mg/kg per day is the starting dose
Which diagnosis should be considered in all patients with sub-acute onset headache presenting with a seizure
CVST- Cerebral venous sinus Thrombosis
Triptans can be used for treatment of migraine for children ? True/False
Yes , Age > 12
Brief electric shock-like pains in the distribution of the trigeminal nerve
Trigeminal Neuralgia
Severe headache, scalp tenderness, jaw claudication and in severe cases, loss of vision
GCA-Giant Cell Arthritis
Brain tumours (primary and secondary)
dexamethasone : 4 mg/day
Most possible cause -If more than one person from the same vehicle or household presents with headache
Carbon Monoxide Poisoning
Raised opening pressure and relief of symptoms after lumbar puncture
Idiopathic intracranial hypertension
New onset of hypertension (over 140/90) after 20 weeks of pregnancy and maternal organ dysfunction
Severe Pre-eclampsia
acute accumulation of extravascular fluid in the lungs following a severe central nervous system (CNS) injury
Neurogenic Pulmonary edema
Idiopathic intracranial hypertension
Furosemide and acetazolamide .Withdrawing 5-10 ml of cerebrospinal fluid will usually relieve the pressure
Which diagnosis should be considered : Unilateral headache associated with face or neck pain, and with a Horner’s syndrome.
Carotid/vertebral artery dissection
IOP measurement ?
Acute closure angle glaucoma
A rare complication of pregnancy where the pituitary gland undergoes ischaemic necrosis following significant peri-and post-partum haemorrhage
Sheehan’s syndrome