1 Headache Flashcards
21 yo F presents with several episodes of throbbing left temporal pain that lasts for 2-3 hours. Before onset, she sees flashes of light in her right visual field and feels weakness and numbness on the right side of her body for a few minutes. Her headaches are often associated with nausea and vomiting. She has a family history of migraine.
MIGRAINE (COMPLICATED) Tension headache Cluster headache Pseudotumor cerebri CNS vasculitis Partial seizure Intracranial neoplasm
Cbc Esr Ct head Mri brain LP
26 yo M presents with severe right temporal headaches associated with ipsilateral rhinorrhea, eye tearing, and redness. Episodes have occurred at the same time every night for the past week and last for 45 mins.
CLUSTER HEADACHE Migraine Tension headache Intracranial neoplasm Pseudotumor cerebri
Cbc Ct head Mri brain LP Esr
65yo F presents with severe, intermittent right temporal headache, fever, blurred vision in her right eye, and pain in her jaw when chewing
TEMPORAL ARTERITIS (giant cell arteritis) Migraine Cluster headache Tension headache Meningitis Carotid artery dissection Pseudotumor Cerebri Trigeminal neuralgia Intracranial neoplasm TMJ disorder
ESR CBC CRP Temporal artery biopsy Doppler U/S - carotid MRI brain LP
30yo F presents with frontal headache, fever, an nasal discharge. There is pain on palpation of the frontal and maxillary sinuses. She has a history of allergies
SINUSITIS Migraine Tension headache Meningitis Intracranial neoplasm
CBC
XR sinus
CT sinus
LP
50yo F presents with recurrent episodes of bilateral squeezing headaches that occur 3-4times/wk, typically toward the end of her work day. She is experiencing significant stress in her life and recently decreased her intake of caffeine.
TENSION HEADACHE Migraine Depression Caffeine or Analgesic withdrawal Hypertension cluster headache pseudotumor cerebri intracranial neoplasm
CBC electrolytes ESR CT head LP
35yo M presents with sudden severe headache, vomiting, confusion, left hemiplegia and nuchal rigidity
SUBARACHNOID HEMORRHAGE Migraine Meningitis/encephalitis intracranial hemorrhage vertebral artery dissection intracranial venous thrombosis acute hypertension intracranial neoplasm
noncontrast CT head LP CBC PT/PTT/INR urine tox
25yo M presents with high fever, severe headache, confusion, photophobia, and nuchal rigidity
MENINGITIS Migraine subarachnoid hemorrhage sinusitis/encephalitis intracranial or epidural abscess
CBC
CT head
MRI brain
LP - CSF analysis (cell count, protein, glucose, gram stain, PCR for specific pathogens, culture)
18yo obese F presents with a pulsatile headache, vomiting, and blurred vision for the past 2-3 weeks. She is taking OCPs
PSEUDOTUMOR CEREBRI tension headache migraine cluster headache meningitis intracranial venous thrombosis intracranial neoplasm
urine hCG
CBC
CT head
LP - opening pressure and CSF analysis
57yo M c/o daily pain in the right cheek for the past month. The pain is electric and stabbing in character and occurs while he is shaving. Each episode lasts 2-4 minutes
TRIGEMINAL NEURALGIA tension headache migraine cluster headache TMJ disorder intracranial neoplasm
CBC
ESR
MRI brain
