Headache
Headache
Headache
Di erential Diagnosis
Serious Causes
Subarachnoid Hemorrhage
Meningitis
Carotid Or Vertebral Artery Dissection
Cerebral Venous Thrombosis
Pituitary Apoplexy
GCA
Intracerebral Hemorrhage Brain
Tumors:1ry or 2ry
Common causes:
Migraine
Tension Headache
Autonomic Cephalgias (Cluster Headache)
Exertional Medication
Overuse Headache
Trigeminal neuralgia
Benign Intracranial HTN
Metabolic Causes (Dehydration,
Hyponatraemia)
Uncontrolled HTN
Errors of Refraction
Referred Pain: Tooth, Ear, Sinuses, Eyes, Face,
Neck
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Other causes:
Brain Abscess,
HIV
Smoking Cessation
Carbon Monoxide Poisoning
Alcohol withdrawal
Analysis Of Complaint
Initially double check What Is Meant By
Headache?
Headache is pain of the head vault.
It is di erent than facial pain or neck pain, but
patients may name all (headache).
Encephalitis / Meningitis
Have You Noticed Any Fevers?
Skin Rash?
PMR/GCA
Is It On The Temporal Side Of the Head?
Increased ICP
Does It Occur In The Early Morning?
Any Fits?
ff
Pituitary Tumors
Signs of Increased ICP: See Before
Acromegaly:
What About Your Shoe And Ring Size,
Do They Fit?
Prolactinoma:
Any Breast Discharge?
Pituitary Apoplexy
Any Sudden Severe Bleeding?
Double Vision?
Migraine
Is It Unilateral?
Is It Preceded By Any Unusual
Sensations, Taste In Your Mouth? Any
Weakness?
Any Blurry Vision? (Aura)
Eased by sitting in Dark Quiet Room?
Cluster Headache
Is It Around the Eyes?
Occurring in Clusters?
Any Watering Of Your Eyes? Redness?
Runny Nose, Nose Blockage?
Does It Occur Several Times In The
Day? Does It Occur At The Same Time
Each Year?
Trigeminal Neuralgia
Any Pain In Your Face, Triggered By
Chewing, Washing Face?
Hypertension
PMH of HTN or New Diagnosis?
Quick Discussion
How Would You Investigate This
Case?
Brain Tumors
fi
Bleeds
SAH Meningitis/Encephalitis
Lumbar Puncture
SAH= Xanthochromia
Meningitis= raised proteins, Raised
WBCs, Glucose abnormality according
to the cause
Idiopathic Intracranial HTN = Raised
opening pressure & therapeutic
Temporal Artery Biopsy = GCA
Pituitary Function tests = Pituitary
Tumors/Apoplexy VBG = CO Poisoning
How Would You Treat This Case
With Headache?
Analgesia