headache: think outside the box
TRANSCRIPT
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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_