Headache: think outside the box

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Oli Flower presents a case of headache with an unusual diagnosis. Hopefully thought provoking. The slides can be seen separately on www.intensivecarenetwork.com and the links to relevant resources can …

Oli Flower presents a case of headache with an unusual diagnosis. Hopefully thought provoking. The slides can be seen separately on www.intensivecarenetwork.com and the links to relevant resources can be found there too. This was presented at last years BCC in Daydream island

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  • 1. think outside the box.
  • 2. ... 61 year old lady sudden onset acute severe headache history of migraines mild nausea no other symptoms mild neck stiffness
  • 3. 36.5 no prescribed meds no focal deficits no meningism
  • 4. LPClear <10 white cells glucose 6 mmol/L Pressure 14 cm CSF no red cells xanthochromia negative
  • 5. .in or out? what next?
  • 6. RCVS
  • 7. history
  • 8. angiogram
  • 9. CSF
  • 10. RCVS
  • 11. RCVS
  • 12. RCVS
  • 13. RxmS
  • 14. think of it identify & stop causes don’t give steroids consider nimodipine consider angiographic interventions _