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Headache Dr Sarah Robinson Consultant Emergency Medicine Southampton Headache
Life-threatening Causes: Subarachnoid haemorrhage Meningitis/ encephalitis Space Occupying Lesion Temporal Arteritis Pre-eclampsia Headache
Other diagnoses to consider Venous sinus thrombosis Dissection Hypertensive encephalopathy Glaucoma/ iritis CO poisoning Headache
Diagnoses you will not make in the ED Migraine Coital cephalgia Exertional headache Headache
History Site Onset Character Radiation Associated symptoms Timing Exacerbating/ relieving Severity Headache
Red flags: history Thunder-clap headache Worse headache ever Syncopal episode Altered mental state Onset with exercise Worse on waking Seizure Headache
Beware... Elderly Immunocompromised Previous neurosurgery (shunts) Headache
Red flags: signs Fever Altered mentation Focal neurology Meningism Headache
Examination Appearance Photophobic Rash Temperature BP Kernigs/ Brudzinski Focal neuro deficit Visual fields Fundoscopy Headache
Subarachnoid haemorrhage Up to 50% initially misdiagnosed – 15% re-bleed early – 40% re-bleed in next 4/52 1 in 10 ED Pts with thunderclap headache Headache
SAH: aetiology Family history Smoking Hypertension Alcohol Cocaine Headache
SAH: history Most thunderclap Worse headache ever Seizure at onset Neck stiffness Headache
SAH: signs May be normal Decreased GCS III CN palsy Retinal haemorrhages Headache
SAH: investigations CT – 98% sensitive if within 12 hours LP Headache
SAH: Management in ED ABCD defG Analgesia Anti-emetic D/W senior CT and refer Headache
SAH: pitfalls “not worse ever headache” “Headache improved with cocodamol” “CT was negative” Headache
Meningitis Headache Fever Neck stiffness Altered mental state Sepsis/ SIRS Headache
Temporal arteritis Older Scalp tenderness Jaw claudication ESR Headache
Summary Thunderclap headache? Senior review Never diagnose migraine in ED Headache
HEADACHE 4 th year module. Introduction Headaches are very common – who hasn’t had one? We see a lot of patients with headache in the ED and the trick.
Headache Catriona Gribbin.
A 42 year old woman became aware of a mild global headache while warming up for her aerobic class. Several minutes later (before the class started), she.
Dr. amal Alkhotani Frcpc neurology, epilepsy
RED FLAGS IN HEADACHE; A HEADACHE FOR THE MAU DOCTOR FAYYAZ AHMED FAYYAZ AHMED CONSULTANT NEUROLOGIST HULL & EAST YORKSHIRE HOSPITALS NHS TRUST.
Morbidity and Mortality Rounds Subarachnoid Hemorrhage Diagnostic Challenges in the ED Neil Collins.
A Case of a Thunderclap Headache Andy Jagoda, MD, FACEP.
Headache Headache affects 75% of population per year (45 million people) and 25% of Neurology OP referrals Daily headache affects 4% of population On.
“It’s all in your head” Kyle McLaughlin Sept. 1, 2005 Diagnostic Imaging Rounds Kyle McLaughlin Sept. 1, 2005 Diagnostic Imaging Rounds.
Approach to patient with Headache. Introduction pain cranium faceneck Headache.
Headaches - In Primary Care Dr M Banerjee GP Registrar Tadworth.
Headache Dr. Mansour Al Moallem.
Neurology Case Based Discussion By Clare Di Bona ED Registrar Dec 2015.
بسم الله الرحمن الرحيم Headache and facial pain Dr.Hayder Kadhum H. FICM NEUR. /Fellow Ship-Luvan university KUFA COLLEGE OF MEDICINE.
Subarachnoid Hemorrhage Nina T
CNS - History taking. Objectives Where is the lesion? What is the pathology –inflammatory/vascular/tumor/infection Is it a CNS manifestation of a systemic.
HOW CAN I BE SURE THIS IS A STROKE ? - DR. INDIRA NATARAJAN LOCUM CONSULTANT LOCUM CONSULTANT UNIVERSITY HOSPITAL OF NORTH STAFFRODSHIRE UNIVERSITY HOSPITAL.
Headaches Continued. Examination 3 minute neurological test.
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