Headache

Question 1

Young mam presented with a progressive headache on the left side with miosis, ptosis, and enophtthlamos? What’s the first diagnosis that comes to mind?

Answer 1

ICA dissection

Question 2

What are the important questions to ask in case of headache presentation?

Answer 2

1. Side of the headache
2. Nature of the headache? Throbbing, stapping ect.
3. Duration
4. Time of the day
5. Fever
6. Photophobia
7. Nausea
8. Vomiting
9. Sesnsory disturbance/ limb weakness

Question 3

What are the primary and secondary caused of headache?

Answer 3

• primary headache;
  1. migraine
  2. tension headache
  3. cluster headache
• secondary syndromes;
  1. ICH & ICA dissection
  2. brain tumor
  3. meningitis
  4. temporal arteritis
  5. Glaucoma

Question 4

What the first and best thing to do to Diagnose ICA dissection?

Answer 4

MRI+MRA

Question 5

What’s the mainstay of ICA dissection treatment?

Answer 5

Anticoagulants or Antiplatelets.