Headache in the Emergency Department: 13 Dangerous Causes

January 15th, 2015
by reuben in .headache

headache ddx.001

 

emergency clinicians do not rule in migraine or other benign causes of headache. unless the headache is congruent to an established pattern for that patient, the history and physical specifically targets these 13 conditions.

subarachnoid hemorrhage: family history, PCKD, known berry aneurysm, sudden and maximal intensity at onset, posterior location

intracerebral hemorrhage: trauma, coagulopathy, decreased level of consciousness, hypertension

CNS infection: fever, immunocompromise, CNS instrumentation, recent head/face infection, meningismus

increased intracranial pressure: slowly progressive, cancer history, worse in morning, worse with head in dependent position, papilledema

carbon monoxide toxicity: contacts with similar illness, locationality (worse at home or at work)

acute angle closure glaucoma: unilateral anterior location, precipitated by darkness, change in vision, red eye

temporal (giant cell) arteritis: elderly, temporal location, jaw claudication, shoulder girdle symptoms

cervical artery dissection: unilateral pain involving neck/face, trauma history

cerebral venous sinus thrombosis: thrombophilia, neurologic signs/symptoms in non-arterial distribution, eyelid edema, proptosis

hypertensive encephalopathy: altered mentation, marked hypertension, improves with antihypertensive therapy

ENT/dental infection: ear, sinus, dental findings

idiopathic intracranial hypertension: young overweight female, hormone use, vision changes

preeclampsia: late pregnancy or postpartum

Back Top

Responses to “Headache in the Emergency Department: 13 Dangerous Causes”

  1. Pingback:Neurology | EMERGENCY FELLOWSHIP links

  2. Pingback:emDOCs.net – Emergency Medicine EducationEM Mindset: Reuben Strayer - 8 Responsibilities of the EM Doc - emDOCs.net - Emergency Medicine Education

Leave a Reply