think outside the box.
... 61 year old lady
sudden onset
acute severe headache
history of migraines
mild nausea
no other symptoms
mild neck stiff...
36.5
no prescribed meds
no focal deficits
no meningism
LPClear
<10 white cells
glucose 6 mmol/L
Pressure 14 cm CSF
no red cells
xanthochromia negative
.in or out?
what next?
RCVS
history
angiogram
CSF
RCVS
RCVS
RCVS
RxmS
think of it
identify & stop causes
don’t give steroids
consider nimodipine
consider angiographic interventions
_
Headache: think outside the box
Headache: think outside the box
Headache: think outside the box
Headache: think outside the box
Headache: think outside the box
Headache: think outside the box
Headache: think outside the box
Headache: think outside the box
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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 be found there too. This was presented at last years BCC in Daydream island

Published in: Health & Medicine
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Headache: think outside the box

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