HA Flashcards
HA: In general, what labs?
cbc
esr
crp
HA: In general, what Images?
CT Head
MRI Brain
HA: In general, what procedures?
LP
HA: specific workups:
Temporal Arteritis?
Temporal Artery Bx
Doppler U/S - Carotid
ESR*
CRP*
*these are part of the general HA workup - but also specific to Temporal arteritis
HA: specific workups:
SAH
CT Head without contrast
LP
PT/PTT/INR
HA: specific workups:
Pseudotumor cerebri
Urine hCG
LP - opening pressure and CSF analysis
21 yo F - throbbing left (unilateral) temporal pain x 2-3 hrs – flashes of light prior to onset – weakness – numbness on right side for a few minutes – n/v – family history positive
migraines
In general, name the list of ddx for HA
“HIM” –> HHIMM
HA
- migraine (unilateral)
- cluster (unilatral)
- tension (bilateral)
Hemorrhages
- SAH
- Intracranial
Inflammation/Infection
- encephalitis
- meningitis
- vasculitis/artertitis (temporal arteritis)
- sinusitis
Masses
- intracranial neoplasm
Misc
- pseudotumor cerebri
- trigeminal neuralgia
26 yo M – right sided (unilateral) temporal HA – rhinorrhea, eye tearing – redness — occur same time every night for past week x 45 minutes
Cluster HA
65 yo – HA – severe, intermittent R (unilatral) temporal – fever, blurred vision in R eye – pain in jaw with chewing
Temporal Arteritis
- another dx: TMJ
HA: specific workups:
Sinusitis
XR - sinus
CT - sinus
- and of course CBC for WBC count
- LP
30 yo F – frontal HA – fever, nasal dc – pain on palpation (be sure to Palpate!!!) to frontal and maxillay sinuses. h/o allergiese
Sinusitis
50 yo bilateral squeezing HA – 3-4 times per week twd end of work day – has major in stress in her life
Tension HA
- add HTN to her ddx
35 yo M – sudden severe HA – vomiting, confusion, L hemiplegia – nuchal rigidity
SAH
25 yo M with high fever – severe HA - confusion, photophobia, nuchal rigidity – +for kernig and brudzinski
Meningitis (bacterial)
Meningtis (HSV)
encephalitis
intracranial abscess
