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Flashcards in FN: Headache differential and investigation Deck (19):
1

Acute headache differentials

VICIOUS
Vascular
Infection/Inflammation
compression
ICP
Ophthalamic
Unknown
systemic

2

Chronic headache differentials

MCD TINGS
Migraine
Cluster headaches
Drugs
Tension headaches
ICP increased or decreased
Neuralgia (trigeminal)
Giant cell arteritis
Systemic

3

Vascular headache causes

1. Haemorrhage: SAH, intracrainal, intracerebral
2. Infarction: esp. posterior circulation
3. Venous: Sinus/cortical thrombosis

4

Infection/Inflammation

Meningitis
Encephalitis
Abscess

5

Compression causes

Obstructive hydrocephalus: tumour
Pituitary enlargement: apoplexy

6

ICP

Spontaneous intracranial hypotension
1. Acute dural CSF leak
2. Worse on standing initially

7

Ophthalamic

Acute glaucoma

8

Unknow causes

Situational: cough, exertion, coitus

9

Systemic

HTN: Phaeo, PET
Infection: sinusitis, tonsillitis, atypical pneumonia
Toxins: CO

10

Drug causes

analgesics
Caffeine
Vasodilators: Calcium antagonists, nitrates

11

ICP changes

increased ICP: tumour, aneurysm, AVM, bening intracranial hypertension

Reduced ICP: spontaneous intracranial hypotension

12

systemic causes of headache

Hypertension
Organ failure e.g. uraemia

13

Investigations

Bloods
Urine
Micro
Radiology
Special: CSF

14

Micro

Blood cultures
Serology: enterovirus (common cause of viral meningitis). HSV, HIV, syphilis, crypto

CSF

15

Radiology

Non-contrast CT: SAH: blood in sulci, cisterns (white). 90% sensitivity in first 24h

MRI:
1. MRA: aneurysm
MRV: sinus thrombosis

16

Special: CSF

Opening pressure (norm = 5-20cm H20)
- raised = SAH, meningitis
- reduced = Spontaneous intracranial hypotension

Xanthochromia: yellow appearance of CSF due to bilirubin. Detect by spectrophotometry

17

Bacterial CSF
Appearance
Cells
Count
Glucose
Protein (g/L)

Turbid
PMN
100-1000
reduced (1.5)

18

TB
Appearance
Cells
Count
Glucose
Protein (g/L)

Fibrin web
Lympho/mononuc
10-1000
reduced (

19

Viral CSF
Appearance
Cells
Count
Glucose
Protein (g/L)

Clear
Lympho/mononuc
50-1000
>1/2 plasma
mild increase (

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