Headache: think outside the box

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. think outside the box.

Transcript of Headache: think outside the box

Page 1: Headache: think outside the box

headache.think outside the box.

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a case... 61 year old lady

sudden onset

acute severe headache

history of migrainesmild nausea

no other symptoms

mild neck stiffness

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36.5no prescribed meds

no focal deficits

no meningism

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LPClear

<10 white cells

glucose 6 mmol/L

Pressure 14 cm CSF

no red cells

xanthochromia negative

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so... in or out?

what next?

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RCVS

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history

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angiogram

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CSF

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RCVS

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RCVS

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RCVS

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RxmS

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think of it

identify & stop causes

don’t give steroids

consider nimodipine

consider angiographic interventionsthe bottom line_


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