Archive:Headache assessment: Difference between revisions
wikademia>Koppertone No edit summary |
wikademia>Wikademia m moved Headache assessment to Archive:Headache assessment |
||
| (6 intermediate revisions by 5 users not shown) | |||
| Line 20: | Line 20: | ||
**stiff neck | **stiff neck | ||
**confusion | **confusion | ||
{{ntnes}} | |||
=='''RED FLAGS OF SERIOUS HEADACHES'''== | =='''RED FLAGS OF SERIOUS HEADACHES'''== | ||
| Line 28: | Line 28: | ||
===More SEVERE and FREQUENT headaches (worst headache ever)=== | ===More SEVERE and FREQUENT headaches (worst headache ever)=== | ||
*mass lesion, subdural hematoma, medication overuse | *mass lesion, subdural hematoma, medication overuse, post-coital headache/migraine | ||
===SUDDEN onset (maximal at onset - no increase over time)=== | ===SUDDEN onset (maximal at onset - no increase over time)=== | ||
| Line 56: | Line 56: | ||
==Family history== | ==Family history== | ||
==Other OSCE modules== | |||
{{OSCE2}} | {{OSCE2}} | ||
[[Category: | [[Category: Neurology]][[Category:OSCE]][[Category: Clinical Skills]] | ||
Latest revision as of 05:51, 7 June 2009
HPI
- FIRST or WORST headache ever?
- DIFFERENT from usual headaches?
- Onset = when did it start?
- gradual, sudden (thunder-clap)
- Palliation/Provokative
- stress, food, menstrual cycle, rest
- Quality
- unilateral, bilateral, band-like?
- does it spread?
- throbbing, stabbing, dull, pressure
- Radiation
- where does it spread?
- Severity
- Nausea/vomiting
- photo/phonophobia
- vision changes
- fever
- stiff neck
- confusion
RED FLAGS OF SERIOUS HEADACHES
New onset
- headaches beginning at age 40
- mass lesion, temporal arteritis
More SEVERE and FREQUENT headaches (worst headache ever)
- mass lesion, subdural hematoma, medication overuse, post-coital headache/migraine
SUDDEN onset (maximal at onset - no increase over time)
- SAH, mass lesion (especially in the posterior fossa)
- new onset in patient with risk factors for HIV or CANCER
- meningitis, brain abscess, metastasis
headache ASSOCIATED with
- fever (meningitis, encephalitis, systemic infection)
- projectile vomiting
- impaired mental status
- focal neurological signs - weakness, paresthesia (mass lesion, stroke)
- recent head injury
- papilledema (mass lesion, pseudotumor, meningitis)
- meningismus (meningeal irritation)
- seizures
- trauma (intracranial hemorrhage, subdural/epidural hematoma, SAH)
PMHx
- hypertension
- HIV
- cancer
- trauma
- recent procedures
Medication
Family history
Other OSCE modules
Acute Confusion - Acute Coronary Syndrome Orders - Anemia - Arterial Blood Gasses - Asthma - Blood Pressure - Chest pain - Chest XRay - CHF - Coma - COPD - Cranial Nerves - Diabetic History - Diabetic Foot - Dysphagia - EKGs - Gallbladder and Liver - Liver Disease - Gait and Balance - Headache - Hematemesis - Hypertension - Jugular Venous Pulses - Knee Exam - Lymph Nodes - Community Acquired Pneumonia - Parkinson Disease - Peripheral Arterial Insufficiency - Pneumonia Examination - Precordial Exam - STD's - Spleen - Swollen Leg Exam - Thyroid Exam - Upper vs Lower Motor Neuron Lesions - Urinary Incontinence