Life threatening HA

Question 1

Subarachnoid Hemorrhage summary

Answer 1

Def: Bleed from ruptured aneurysm or arterial venous malformation

SS:
"worst headache of life"
sudden onset
LOC
focal near signs
seizure
nuchal rigidity

Eval:
CT
lumbar puncture

Txt:
Nicardipine (CCB)
Phenytoin
Urgent neurosurgical consult

Question 2

Meningitis summary

Answer 2

Def: bacterial/viral infection in CSF

SS:
HA
fever
toxicity
Nuchal rigidity
Vomiting

Eval:
lumbar puncture

Txt:
Bac: IV, steroids
Viral: supportive

Question 3

Subdural Hematoma summary

Answer 3

Def: bleeding between dura and arachnoid/brain with significant brain injury
Cause: tears of bridging veins between cerebral cortex and dura
SS:sickle shape
HA with confusion obtundation
Elderly/aloholics
CT

Question 4

Epidural Hematoma summary

Answer 4

Def: bleeding between inner skull table and dura with no brain injury
Cause: skull fx tear middle meningeal artery
SS: lenticular
Brief LOC -> awake with HA -> deteriorating mental status
rapidly progress to herniation of brain
CT
neurosurgery -> good prognosis

Question 5

Hypertensive HA summary

Answer 5

Diastolic BP > 130

alleviate via BP control with antihypertensives