1. A Few Random Thoughts About Headaches CCFP (EM) Rounds Dec 17 th, 2009 Ian Walker

3. What Will We Be Talking About? Migraine SAH Workup Significant CT negative HA’s Trigeminal Neuralgia Cluster Headache

4. Migraine Define It!! Treatment Options?

5. STEROIDS, ANYONE?

7. Worrisome Features for SAH Thunderclap Exertional or Coital Vascular Risk Factors Family History Meningismus Altered LOC

8. The LP Controversies When? What constitutes positive? Checking for Xantho

9. Differential?

11. A Case This Woman Waxing and waning headache for 4 days Diplopia yesterday, none now Worse supine Nausea No history of same Slight weakness on L

12. Dural Sinus Thrombosis Think elevated ICP Think DVT of the brain Think CT Venogram Think LP Think about it

13. Intracranial Dissection

14. What Should Make You Think About It? Manipulation Trauma (MVC, etc) Neuro findings Horner’s Cerebellar Findings

15. Another Case This Patient 1 week of headache Worse in am Worse laying down Intermittent Visual blurring What’s The Best Test?

16. Does this 48 year old Man have GCA?

18. Cluster Headache Severe, unilateral Rhinorhea and lacrimation Headaches “cluster” temporally O2, lidocaine, verapamil, pre-gabalin Great patient for a neurologist

20. PUTTING IT ALL TOGETHER