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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. Classification Primary: 90% No structural abnormality Migraine Tension-type Cluster Secondary: 10% Underlying cause Subarachnoid.
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.
Approach to Headache 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.
Subarachnoid Haemorrhage Dr Mark Putland MBBS FACEM Co-DEMT.
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. HEADACHE RELATED TO ETIOLOGY… Vascular… Migraine Muscle contraction… Tension headache Inflammatory… Giant cell artritis.
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. Gentile, MD Associate Professor Division of Emergency Medicine Temple University School of Medicine Philadelphia, PA.
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.
Subarachnoid hemorrhage Dr. Ari Sami Hussain Nadhim Consultant Neurosurgeon Scxhool of Medicine University of Sulaimani 2013 Dr. Ari Sami Hussain Nadhim.
Headache Headache is one of the commonest neurological complain reported at neurology clinic
Headache Guideline Cumbria Cumbria Partnership NHS FT- Neurology Department Headache Clinic Penrith Headache Guideline Cumbria Cumbria Partnership NHS.
Recognition of the unwell patient And what to do about it Dr Mike Nicholls Emergency Medicine Consultant Auckland City Hospital April 2011.
5) Migraine Throbbing pain lasting hours - 3 days Sensitivity to stimuli: light and sound, sometimes smells Nausea Aggravated by physical activity (prefers.
New Onset Headache: Diagnosis and Management Michelle Biros MS, MD Dept. Emergency Medicine Hennepin County Medical Center.
Headache. Agenda History Physical Classification Management.
VISUAL LOSS IN THE ELDERLY. Aetiology Sudden –Retinal Retinal vascular occlusion Wet AMD –Neurological AION Neurological visual field loss Gradual –Cataract.
A Few Random Thoughts About Headaches CCFP (EM) Rounds Dec 17 th, 2009 Ian Walker.
Philip Bossart, MD 1 Headache Treatment: What’s the Latest?
Dr. Hossam Hassan. 46-year-old female with a history of migraine headaches who presents with a severe, constant pain that started suddenly while running.
بسم الله الرحمن الرحيم كل عام وانتم بخير Headache and facial pain Dr.Hayder Kadhum H. FICM NEUR. /Fellow Ship-Luvan university KUFA COLLEGE OF MEDICINE.
Department of Neurology, SJUH Acute headache Problems that can not wait until the post take ward round
Imaging in headache patients “Incidentalomas” Giles Elrington Barts & The London
Approach to the Patient with Head and Facial Pain Neurology
The differential for thunderclap headaches Neurology Resident Teaching Series.
“My head hurts” Aliza Moledina MS3 Emergency Medicine Clerkship Rotation PAL Session April 29 th, 2015.
Scott Silvers, MD, FACEP Optimizing Headache Management in the ED: A Focus on Subarachnoid Hemorrhage.
WNV – Ontario 2002 Preliminary Overview of Human Case Questionnaire Data.
آقـای 80 سـالـه CC : درد سمت چپ سر و تاری دید چشم چپ مشکل بیمار از یک هفته قبل از بستری با درد شدید سمت چپ سر در ناحیه گیجگاهی شروع شده است – تهوع و استفراغ.
Subarachnoid hemorrhage extravasation of blood into the subarachnoid space between the pial and arachnoid membranes.
Meningitis. Learning objectives Gain organised knowledge in the subject area of meningitis Be able to correctly interpret clinical findings in patients.
E. Bradshaw Bunney, MD, FACEP Optimizing Headache Management in the ED: A Focus on Subarachnoid Hemorrhage.
A few headache cases. GA 1 Please see this 65 y.o. retired shoe designer with occipital headaches for 3 months not helped by physiotherapy. Woken at night.
Intracranial infection. Objectives To know about clinical presentation of meningitis and Encephalitis To know about the common infective organisms responsible.
ACEP Clinical Policy: Adult Headache Patients. Ponte Vedra Beach, FL June 24, Clinical Decision Making in Emergency Medicine Ponte Vedra Beach,
Red Flags Dr. Ahmed A. Elbashir ED Consultant KFMC Assistant Prof. KSU.
E. Bradshaw Bunney, MD, FACEP The Diagnosis of SAH in ED Headache Patients: What Roles for CT Neuroimaging and Lumbar Puncture?
Steve Elliot GPwSI Headache. History taking in episodic headache History taking in chronic headache 3minute neurological examination Who to refer.
Utility of Red Flags in the Headache Patient in the ED L. Garcia-Castrillo, MD, SEMES Department of Emergency Medicine University Hospital Marques de Valdecilla.
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