Secondary Headache due to raised intracranial pressure and space-occupying lesions

Question 1

Characteristics

Answer 1

worse when lying down
morning vomiting
night-time waking
change in mood, personality, or educational performance

Question 2

Features suggestive of SOL

Answer 2

visual field defects
cranial nerve abnormalities
abnormal gait
torticollis
growth failure - craniopharyngioma or hypothalamic lesion
papilloedema - late
cranial bruits- AV malformations
early or late puberty

Question 3

Visual field defects

Answer 3

craniopharyngioma (a pituitary tumor)

Question 4

cranial nerve abnormalities - VIth abducens

Answer 4

false localising sign - other nerves are affected depending on the site of the lesion
diplopia
squint
inability to abduct the eye beyond the midline

Question 5

pontine lesions

Answer 5

VIIth CN
facial nerve palsy