Headache Flashcards
1
Q
ΔΔ headache with no signs on examination?
A
- tension
- migraine
- cluster
- post-traumatic
- drugs (nitrates)
- CO poisoning
- SAH
2
Q
red flags to ask?
A
- first and worst
- thunderclap
- unilateral, eye pain
- unilateral, ipsilateral Sx
- cough-initiated
- worse in morning/bending forward
- persistent + scalp tenderness, >50
- fever +/- neck stiffness
- change in usual headaches
- ↓ LOC
3
Q
what to Ex in headache?
A
- meningism - photophobia, neck stiffness, fever, rash, pain + resistance on passive knee extension w/ hip flexed (Kernig’s sign)
- focal neurology - sensory/motor/visual deficit, seizures
- ↓LOC
- papilloedema
- eye P. (glaucoma)
- temples (GCA)
4
Q
ΔΔ headache with ↓LOC or localising signs?
A
- clot (stroke)
- infection (enceph, mening, abscess)
- bleed (SAH, subdural haematoma)
- SOL (tumour, TB)
- venous sinus thrombosis
5
Q
ΔΔ headache with papilloedema?
A
- tumour
- venous sinus occlusion (focal Sx)
- malignant HT
- IIH
- CNS infection > 2weeks (TB)
6
Q
Hx: headache, tender scalp over temporal arteries and high ESR?
A
GCA
7
Q
Hx: headache, neck pain, and cerebellar/medullary signs?
A
vertebral artery dissection
8
Q
Hx: headache, recent URTI, phlegm?
A
sinusitis
9
Q
Hx: first and worst headache like a thunderclap?
A
SAH
10
Q
Hx: unilateral headache with ipsilateral Sx?
A
- migraine
- tumour
- vascular
11
Q
Hx: cough-initiated headache, which is worse in morning/bending forward?
A
raised ICP/venous thrombosis
12
Q
Hx: headache, fever +/- neck stiffness?
A
meningitis
