Headaches Flashcards
Is a rapid onset headache typically concerning?
Yes
What can cause a rapid onset headache?
Sub-arachnoid haemorrhage
Meningitis
Encephalitis
How is a sub-arachnoid haemorrhage often described?
‘Worst ever headache’
‘Thunderclap headache’
Where in the head does a headache caused by a sub-arachnoid haemorrhage typically occur?
Occipital region
How does a sub-arachnoid haemorrhage affect consciousness?
Decreased consciousness
What can a sub-arachnoid haemorrhage cause within the cranium?
Raised ICP
What are some signs of raised ICP that can be seen in GP?
Papilloedema on fundoscopy
History of nausea and vomiting
Double vision (diplopia)
Why does raised ICP cause double vision?
Raised ICP disproportionately affects the VI cranial nerve
Why does ICP disproportionately affect the VI cranial nerve?
Because it has the longest intracranial course
What is the name of the VI cranial nerve?
Abducens
What muscle is innervated by the abducens?
Lateral rectus
What other symptoms accompany meningitis?
Fever
Photophobia
Purpuric, non-blanching rash
Neck stiffness
What other symptoms accompany encephalitis?
Odd behaviour
Fits
Fever
How should suspected encephalitis be investigated?
Urgent CT scan
What can cause a gradual onset headache?
Sinusitis
Tropical infections
Venous sinus thrombosis
Intra-cranial hypotension
What sign may suggest venous sinus thrombosis?
Papilloedema
What can make sinusitis pain worse?
Bending over
How is a headache caused by sinusitis described?
Dull, constant headache in the distribution of the nasal sinuses
What does palpation of the area over inflamed sinuses elicit?
Tenderness
Why might a tropical infection be a suspected cause of a headache?
A travel history with accompanying flu-like symptoms