Non-traumatic Acute Headaches

Question 1

what is the goal when a patient presents with an acute headache?

Answer 1

identify potentially life-threatening conditions

Question 2

what are the red flags? (5)

Answer 2

Systemic symptoms

Neurological symptoms

Onset is new (esp. over 50 yo)

Other conditions/features

Previous headache history is progressing or changing

Question 3

in which cases of acute headache onset are we concerned for increased ICP? (4)

Answer 3

after:
valsalva/cough
position change
exertion
sexual activity

Question 4

what is the preferred imaging? (2)

Answer 4

CT head
OR
MRI head

Question 5

in which 3 cases is imaging emergent?

Answer 5

abnormal neuro exam
AMS
thunderclap headache (SAH)

Question 6

in which 2 cases is imaging urgent (must be done within 48 hours)?

Answer 6

HIV positive
over 50 years old

Question 7

what vital sign should we get to determine if patient has carbon monoxide poisoning?

Answer 7

co-oximeter reading

Question 8

what part of the physical exam is important in patients older than 60?

Answer 8

palpate for scalp/temporal artery tenderness