headache d1

Question 1

HA/new HA/

hyperacute or acute onset + NS signs/

think

Answer 1

hemorrhage:

an_eurism=>sub^arachnoi_{d he}morrh_age; SAH

he_morrha_{gic str}oke;

HA due to SAH- like

co_ugh.

s^exual or

ex_ertional

hint: something that pops suddently, u do it or it just happens

Question 2

overall frame (+ questions to ask)

for the diff dx of new HA

Answer 2

serious and super emergent:

HA=> neur^ologic de^ficits sx?

serious and emergent/I=infection

gal: fe_ver; con^fusion; men^ingitus

serious+ non emergent

CC: Q_uality of the HA: H_A thr_obing

ass. Sx: ; ab_{nl te}m^{poral a}rt; ja^{w clau}dication/

not that serious+ non emergent:

rx and SHx: ne_{w rx} add^{ed or red}rawn or ov^erused

Question 3

HA/new HA/serious + super emergent/

dx (“3”)

Answer 3

hemorrhage:

1. su^barachnoi^{d hem}orrhage;
2. hem_orrhagic ^stroke;
3. HA due to co^{ugh. se}xual or ex^ertional = all lo^{oks li}ke S^AH

Question 4

HA/new HA/serious + super emergent/

imaging tests

Answer 4

no_{n co}ntrast hea^{d C}T;

if nl=> L^P

hint: is there blood?

Question 5

HA/new HA/serious + emergent/

dx (2)

Answer 5

cause: infection/

1. me_ningitis
2. en_cephalit^is

Question 6

HA/new HA/serious + emergent/

imaging

Answer 6

NO NS=>

possible to consider ^{LP w or W/o} imaging

Question 7

HA/new HA/

serious + non emergent/

possible sx n possible dx

Answer 7

sx:

1. H_{A throbb}ing or
2. ab^{nl te}mpo_{ral ar}teris;
3. ja_{w cl}audic^ation
4. visu_{al cha}nges

dx:

1. tempo_{ral art}eritis;
2. Idio_pathic Int^racranial hyp^ertension

Question 8

HA/new HA/serious + non emergent/

test

Answer 8

fu_ndoscopi^{c exa}m

if temporal arteritis: high suspicion=>

1. c_orticosteroid +
2. get te_mpor^{al bx}

Question 9

HA/new HA/not that serious + non emergent/

dx

Answer 9

HA caused by

1. n_ew
2. ab^used or
3. wit_hdrawn substa^{nce or} r_x

Question 10

HA/new HA/not that serious + non emergent/

next/possible tx

Answer 10

with_{draw the s}ubsta_{nce or}

moni_{tor re}sp to su^pportive c^are

Question 11

HA/old HA/ suspected migraine/

which questions to ask?

Answer 11

P_OUNDiⁿg mnemonic

Question 12

algo for old HA

Answer 12

old= primary HA=>

1. mi_graine? T_ension?cl^uster?
2. sx of ch_{ronic dz}=cerv_{ical DJ}D; pai_{n syn}dro^me; de^pressi^on
3. consider atyp_{ical pri}mary H^{A syn}drome

hint: ck 3=atypical presentation of primary HA