https://idwiki.org/index.php?action=history&feed=atom&title=Acute_severe_headache 2026-05-19T09:09:35Z Revision history for this page on the wiki MediaWiki 1.43.8 https://idwiki.org/index.php?title=Acute_severe_headache&diff=4070&oldid=prev 2020-07-04T01:17:21Z

<p>Imported from text file</p> <p><b>New page</b></p><div>== Differential Diagnosis ==<br /> <br /> * Trauma<br /> * Primary<br /> ** Crash migraine<br /> ** Cluster headache<br /> ** Benign thunderclap headache<br /> *** Orgasmic cephalalgia<br /> *** Exertional headache<br /> * Vascular<br /> ** Subarachnoid hemorrhage<br /> ** Ischemic stroke<br /> ** Hemorrhagic stroke<br /> *** Hypertensive hemorrhage<br /> ** Arterial dissection<br /> ** Pituitary apoplexy (rare)<br /> * Psychogenic<br /> <br /> == Investigations ==<br /> <br /> * Glasgow coma scale (GCS)<br /> * Non-contrast CT scan<br /> ** Most sensitive in first 12-24 hours<br /> ** Assesses for hydrocephalus and associated intracranial hemorrhage<br /> * Lumbar puncture<br /> ** Differentiate SAH from traumatic tap<br /> ** Xanthochromia indicates SAH that develops 12 hours and can last 2 weeks<br /> *** Slight yellow tinge<br /> * Vascular imaging<br /> ** CTA is best, followed by MRA<br /> ** Can consider traditional angiogram<br /> <br /> == Management ==<br /> <br /> * CT neg, LP neg: stop<br /> * CT neg, LP pos: angiogram<br /> * CT neg, LP not done: ???<br /> * Acute non-SAH headache:<br /> ** Normal saline 1L IV<br /> ** Metoclopramide IV<br /> ** Toradol IV/IM/po<br /> ** Avoid narcotics outside of acute<br /> <br /> [[Category:Neurology]]</div>

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