Acute headacheAcute headache
Problems that can not wait until the post take ward round
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History
Examination
Investigations
The most important investigation in the evaluation of headache is the history
Department of Neurology, SJUH
Department of Neurology, SJUH
Headaches in A&E
Prospective study of all patients with a primary diagnosis of headache
93 cases in 3 months
39 (42%) had sudden onset headache
30 (32%) had a CT scan
Department of Neurology, SJUH
Headaches in A&E
Migraine
Aura symptoms: visual (99%), sensory (31%), dysphasia (18%), motor (6%).
Department of Neurology, SJUH
At least two of following characteristics: unilateral, pulsating, moderate to severe, aggravated by movement
At least one associated symptom: nausea or vomiting, photophobia, phonophobia
Department of Neurology, SJUH
Gradual development of aura symptom over >4 mins
Aura symptoms last 4-60 mins
Headache follows or accompanies the aura within 60 mins.
Department of Neurology, SJUH
Miosis, ptosis, eyelid oedema
Department of Neurology, SJUH
Tight or pressure pain
Department of Neurology, SJUH
Associated with vomiting, visual blurring, features due to underlying lesion
Papilloedema