Intracranial Vascular Causes of Headache
Arteriovenous nicking, flame-shaped hemorrhaged, cotton wool spots and papilledema may be present on fundoscopic examination.
What is severe systemic HTN?
Study of choice to evaluate for presence of intracranial tumor.
MRI. CT can miss lesions of the posterior fossa or non-enhancing tumors (eg, low-grade gliomas)
This condition should be ruled out in the immediate evaluation of anyone with impaired consciousness.
What is hypoglycemia?
A 28-year-old Greek man with microcytic anemia and codocytes (target cells) on peripheral blood smear.
What is Thalassemia?
Associated with AGMA and asterixis.
What is uremia?
Headache in patient with polycystic kidney disease.
What is a cerebral aneurysm?
Describe the headache associated with intracranial tumors.
What is bifrontal, worse on side of tumor, similar to tension headache, worse with bending over, associated with N/V, more noticeable in AM?
Delirium, jaundice, and coagulopathy.
What is liver failure?
Liver failure and hyperammonemia leads to increase in inflammatory signals and response. Also, glutamine from ammonia is an osmolyte that causes cerebral edema and increased intracranial pressure.
Associated with microcytic anemia and basophilic stippling on the peripheral blood smear.
What is Lead Poisoning?
A 45-year-old man with peptic ulcer disease presents with hypercalcemia and metabolic alkalosis.
What is exogenous alkali? (Like milk alkali from antacid use)
72 year old man with vascular disease present with acute-onset vertigo, ataxia, and homonymous hemianopsia.
What is posterior circulation stroke?
What is the most common type of primary intracranial tumor in adults?
What is Glioma - more than 1/2 cases and Glioblastoma Multiforme is the most frequent subtype.
Seizure in a marathon runner who rehydrates with water.
What is hyponatremia?
Tick-bourne disease that can cause hemolytic anemia
What is Babesiosis?
Hyperventilation and respiratory alkalosis can be the first sign of this infectious process associated with end-organ dysfunction and decreased systemic vascular resistance.
What is sepsis?
This acute vascular event is a common cause of stroke in young patients and may occur within the anterior or posterior circulations.
What is arterial dissection?
Carotid and vertebral arteries are the intracranial vessels most often associated with dissection.
Which types of cancers are most commonly associated with brain metastases?
Lung cancer is more than 1/2 of all metastatic cases to brain. Breast CA, melanoma, RCC, and colorectal cancer are most of the other cases.
Tremor, hyperreflexia, and a generalized seizure
What is hyperthyroidism?
A 56-year-old man with recent-onset hair loss, peripheral neuropathy, and pancytopenia has had recurrent hospital admission for abdominal pain, vomiting, diarrhea, and delirium, which seem to occur only after consuming meals prepared by his wife.
What is arsenic poisoning?
These 2 inherited conditions mimic the effects of loop and thiazide diuretics, respectively.
Bartter's and Gitelman's Syndromes.
results in elevated RAAS levels and increased delivery of Na and H2O to the distal nephron, which increase H+ secretion, causing metabolic alkalosis.
Nosebleeds, hemoptysis, and cutaneous telangiectasias.
What are AVM related to hereditary hemorrhagic telangiectasia?
How common are intracranial tumors?
What is 12 in 100,000 persons?
Acute episodes of abdominal pain, polyneuropathy, and urine that turns red over time.
What is acute porphyria?
Hemolytic anemia, chocolate-colored blood, and hemoglobin oxygen saturation of 85% by pulse oximetry.
What is Dapsone toxicity?
Mechanism of cause of respiratory alkalosis associated with spider angiomas on the chest.
What is progesterone, metabolized by the liver. This is elevated in patients with cirrhosis and can stimulate hyperventilation via progesterone receptors in the CNS. Estradiol, which is also elevated in the serum of patient with cirrhosis, may potentiate the effects of progesterone by increased the number of receptors.