Headache/ Head Injury Flashcards
Central venous sinus thrombosis
Think any DVT risk factors, look for a headache with neuro deficits. Call vascular and get a CT venogram
Need LP if CT negative within 6 hours of headache onset?
Not usually - 100 sensitivity for SAH, within 6 hours
When CT before LP?
Get the CT before the LP- structural, new seizure, altered LOC, focal deficit, papiledema, immuncompromised
Should you delay antibiotics in a septic patient?
No. Always get the abx in as fast as possible, get blood cultures and then push - try within an hour
Tx for meningitis
Ceftriaxone 2g IV, vancomycin 20mg/kg IV, dexamethasone 10mg IV , acyclovir
Way think of a DDX for HA?
Intracranial
Extracranial
Stroke questions
Neuro sx, last seen well, blood thinners, risk factors, handedness can do a NIHSS
What do you always need to rule out before diagnosing a stroke?
Hypoglycaemia
CT finding for SAH
The Death Star - white blood outlining the circle of Willis
Shape of subdural on CT
Crescent shaped - can be quite subtle
Epidural on CT
Biconvex shaped, talk and die presentation, middle meningeal artery
Headache treatment
Toradol, 500 IV fluids, and maxran
Cluster headache patho physiology
Dilation of the internal carotid and meningeal artery supplied by trigeminal
Cluster headache sx
Unilateral retro-orbital, ipsilateral parasympathetic- lacrimation, red eye, sweating, edema
HA in pregnancy tx?
First rule out pre-e/ pathology then can tx with Tylenol +/- fluids and maxeran