headache: think outside the box
TRANSCRIPT
headache.think outside the box.
a case... 61 year old lady
sudden onset
acute severe headache
history of migrainesmild nausea
no other symptoms
mild neck stiffness
36.5no prescribed meds
no focal deficits
no meningism
LPClear
<10 white cells
glucose 6 mmol/L
Pressure 14 cm CSF
no red cells
xanthochromia negative
so... 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 interventionsthe bottom line_