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Serious causes of HA, S&S and management
Brain TumoursTriad | Other S&S | Headache | Nausea | Vomiting | Worse first thing in the morning | Convulsions | Valsalva movements make it worse | | | new onset/change in HA | | | Seizures | | | Confusion | | | Dysphagia | | | Motor Weakness | | | Personality Changes | | | Memory Loss |
Triad in childrenDizziness | Headache | Vomiting |
| | Temporal ArteritisS&S | Persistant unilateral throbbing over temporal region + scalp tenderness | Associated with PMR - look for bilateral inflammatory signs over shoulder/hip area | >50y | Severe burning - worse in morning & constant | Malaise, vague aches, pains, weight loss | ESR/CRP elevated |
MangementUrgent referral (same day) to GP - risk of blindness |
| | Thunderclap HAS&S | Causes | Management | Sudden, abrupt Headache - Reaches peak @ 1 hour | SAH | REFER IMMEDIATELY TO HOSPITAL | "Worse Headache of their life" | Intracranial haematoma | DON'T LET THEM DRIVE | "Feels as though they are being hit on the back of the head" | Cerebral venous sinus thrombosis | Very Different type of Headache | Cervical Artery dissection | | | Ischaemic Stroke |
MeningitisS&S | Severe Headache | Neck Stiffness | High Fever | Altered Mental State | Photo/Phonophobia |
ManagementRefer immediately to hospital - dial 999 | CRP, FBC, blood cultures, lx puncture |
Serious Signs of HA in ChildrenPresent in the morning | Wakes Child at night | No PMHx | No Family Hx | Associated Poor health | Associated Neuro symptoms | Presents unilaterally |
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