What are the signs and symptoms of meningitis?
- Severe
- Global headache
- Neck stiffness
- Fever
- Photophobia
- Purpuric rash
- Coma
How should meningitis be investigated?
- CT head scan
- Lumbar puncture if no rasied intracranial pressure
- Culture and specimen
Outline the causes of a subarachnoid haemorrhage
- Rupture of the berry aneurysm
- Arteriovenous malformation
Describe the pathophysiology of a subarachnoid haemorrhage
- Rupture of berry aneurysm common at the junction of posterior communicating with internal carotid
What are the signs and symptoms of a subarachnoid haemorrhage?
- Thunderclap headache (worse headache ever)
- Sudden onset headache at occipital
- Stiff neck
- Decreased consciousness
- Reduced GCS
- N+V
- Coma
- Focal neurology (pupil changes indicating 3rd nerve palsy with PCA)
- Confusion
How should a suspected subarachnoid haemorrhage be investigated?
- CT head
- Lumbar puncture if no RICP (blood in CSF)
How should a subarachnoid haemorrhage be managed?
- Refer to neurosurgery immediately
- Re-examine CNS often
- Aim BP <160
What are the signs and symptoms of a head injury?
- Pain at site
- Pain may be global
- Pain can last for 2 weeks
- Pain is resistant to analgesia
How should a head injury be investigated?
- CT head
What are the sign and symptoms of sinusitis?
- Pain around the sinuses when leaning forward or bending forward
- Dull constant ache over frontal/maxillary sinuses
- Tenderness
- Postnasal drip
What are the possible triggers of a migraine?
- CHOCOLATE
- Chocolate
- Hangover
- OCP
- Coffee/Cheese
- Orgasms
- Lie ins
- Alcohol
- Travel
- Exercise
What are the signs and symptoms of a migraine?
- Photosensistivity
- Unilateral throbbing(focal)
- Aura
- Nausea and vomiting
- Slurred speech
- Weakness/numbness
How should a migraine be managed with non-pharmacological therapies?
- Warm/cold packs to the head
- Breathing into a paper bag
- Lying in a dark room
- Acupuncture
What is the prophylactic treatment for migraines?
- Propanolol
- 12 weekly botulinum toxin type A i injections and are the last resort
What is the treatment of a migraine during an attack?
- Oral triptan with NSAID or paracetamol
- Monotherapy with any of the above
- Anti-emetics
What are the signs and symptoms of a cluter headache?
- Unilateral headache
- pain behind eye
- Bloodshot and watery eye
- Unilateral sweating and lacrimation
- Facial swelling
- Swollen eyelid
- Runny nose
- Pain usually comes on at night or at the same time during the day and lasts for the same amount of time (15-180 mins)
How are cluster headaches treated?
- Acute attack
- Oxygen
- Sumatriptan
How are cluster headaches prevented?
- Avoid triggers such as alcohol
- Medication
- Corticosteroids
- Verapamil
- Lithium
What is trigeminal neuralgia?
- Trigeminal neuralgia is a chronic pain condition that affects the trigeminal nerve, which carries sensation from your face to your brain.
- If you have trigeminal neuralgia, even mild stimulation of your face — such as from brushing your teeth or putting on makeup — may trigger a jolt of excruciating pain.
What are the symptoms of trigeminal neuralgia?
- Intense, stabbing pain, lasting seconds in the trigeminal nerve distribution
- Unilateral pain
- Affects the mandicular and maxillary divisions
What are the triggers of trigeminal neuralgia?
- Wasing affected area
- Shaving
- Eating
- Talking
- Dental prostheses
How is trigeminal neura;gia inveastigated?
MRI to exclude other causes of the symptoms
How is trigeminal neuralgia managed?
- Nerve pain management
- Carbemazipine
- LAmotrogine
- Phenytoin
- Gabapentin
- If drugs fail, surgery may be necessary
- Gamma knife surgery
What are the signs and symptoms of GCA?
- Tender thickened temporal head
- Pulseless temporal arteries
- Jaw claudication
- Vision loss/changes
- Combing hair causes pain
