Describe the pathophysiology of venous sinus thrombosis
Thrombus within the venous sinuses of the brain, which prevents blood from drainage from the brain, resulting in raised ICP
Describe the clinical presentation of venous sinus thrombosis
- Headache
- Vomiting
- Papilloedema
What are the risk factors for venous sinus thrombosis?
- Oestrogen e.g. pregnancy, COCP use
- Clotting disorders, e.g. antiphospholipid syndrome, Factor V Leiden mutation
- AZ COVID vaccine?
Describe the investigation of venous sinus thrombosis
Brain imaging (CT/MRI)
Describe the management of venous sinus thrombosis
Anticoagulation
Give some risk factors for idiopathic intracranial hypertension
- Female
- High BMI
What are the symptoms and signs of idiopathic intracranial hypertension?
- Headache
- Vomiting
- Papilloedema
Describe the conservative, medical and interventional management of idiopathic intracranial hypertension
Conservative:
- Weight loss
Medical:
- Diuretics, e.g. acetazolamide
Interventional:
- Repeated LP
Describe the acute and prophylactic management of cluster headaches
Acute:
- 100% oxygen and S/C sumatriptan
Prophylaxis:
- Verapamil
When are triptans contraindicated?
Ischaemic heart disease
Describe the acute and prophylactic management of migraine
Acute:
- Sumatriptan
Prophylaxis:
- Propanolol
- Topiramate
Give an example of a situation where you WOULDN’T prescribe beta blockers for prophylactic management of migraines and would instead choose an alternative medication
Patient has asthma
