treatment faculty group 504-c

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powerpoint presentation treatment faculty group 504-c by temirov farkhod secondary headaches disclosures reference arial 10pt left aligned footer arial 10pt right aligned 2 allergan: advisory board, research support, speaker’s panel amgen: advisory board promius pharma: advisory board supernus: advisory board teva: advisory board eli lilly: advisory board, research support curelator: consultant paid in options 1. to recognize “red flags” for headaches with a discernable cause is it time to rename “secondary headaches”? 2. to reinforce understanding on how to diagnose, manage and treat dangerous and rapidly progressive headaches due to specific causes. 3. to review headaches that we may not encounter on a regular basis. how much of our practice is primary headache disorders due to access reasons? who is actually taking care of these patients? reference arial 10pt left aligned footer arial 10pt right aligned 3 learning objectives diagnosis and testing detailed history and examination preliminary diagnosis primary headache? …

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verity and quality associated features aggravating factors exam general exam! neurologic exam hx pe the diagnosis of headache is based on a thorough history of headache, general medical history, and a detailed physical and neurological examination.1 some primary headache syndromes such as migraine and cluster headache are usually easily recognizable based on clinical observations and history. in other headaches that do not fit specific patterns, appropriate diagnostic tests should be performed. in addition to ruling out structural or organic conditions that cause headache, these tests serve as a reassurance to an anxious patient who is worried about an impending serious illness as the cause of headache. fear of a brain tumor, aneurysm, or other structural abnormality is common among the headache population. patients consult a physician not only for relief of pain but for an explanation of their pain.2 therefore, reassurance is important in the successful management of patients with …

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ary leptomeninges high and low intracranial pressure syndromes mra = magnetic resonance angiography mrv = magnetic resonance venography bousser mg, et al. in: wolff’s headache and other head pain. 2001. dodick dw. adv stud med. 2003;3:s550-s555. 7 organic causes for headache missed by ct scanning routine ct or mri scanning are not recommended for routine evaluation of headache. however, specialized imaging techniques, such as contrast enhancement, can provide critical diagnostic information under appropriate circumstances. in the magnetic resonance venography image presented, a venous sinus thrombosis causes contrast material to illuminate the superior subarachnoid sinus (arrow). sinus thrombosis may present clinically as a thunderclap headache (a type of headache that more often is seen with subarachnoid hemorrhage). bousser mg, good j, kittner sj, silberstein sd. headache associated with vascular disorders. in: silberstein sd, lipton rb, dalessio dj, eds. wolff’s headache and other head pain. 7th ed. new york: oxford university press; …

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e arial 10pt left aligned footer arial 10pt right aligned 10 will focus on selected disorders: headaches secondary to vascular disorders headaches associated with spinal fluid disorders headaches associated with cns infections potpourri vascular headaches… 11 secondary headache: subarhachnoid hemorrhage first or worst headache often missed maximum headache in 90%, lp + early in 100% subarachnoid hemorrhage: beware of blood in the pits parenchymal intraventricular truncal sulcal self-explanatory 13 subarachnoid hemorrhage risks: rebleed and vasospasm early surgery, then increase perfusion 10% have multiple aneurysms best evidence: control blood pressure! intracerebral hemorrhage focal deficits plus headache progresses quickly difficult to arouse if hemosiderin staining and young think cavernoma if older think amyloidosis reversible cerebral vasoconstriction syndrome (rcvs) rcvs most commonly precipitated post-partum or with the use of vasoactive substances cannabis cocaine ssris binge drinking nasal decongestants may result in: sah ich stroke pres treated with iv/po calcium channel blockers ducros et …

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with migraine pulsatile tinnitus, tvos papilledema enlargement of blind spot loss of inferonasal field other 6th nerve palsy in 10 – 20% empty sella lateral sinus abnormality pseudotumor risk factors include female gender and obesity not all cases are idiopathic increased risk of thrombosis with cigarette smoking and with the use of oral contraception. nordic iiht trial demonstrated safety and efficacy of acetazolamide for pseudotumour 38/86 tolerated the 4 grams per day in study there is mixed evidence for the use of stenting shunts are possible, but complications common optic nerve fenestration is option to preserve vision 21 mri findings in pseudotumor gadolinium-enhanced mr venography findings in patients with iih. lao and rao segmented maximum intensity projections on (a and b) patient 77; (c and d) patient 36; and (e and f) patient 8. (a) discontinuities (scored as = 0) are seen (arrows) in the right transverse sinus in (b). …

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powerpoint presentation treatment faculty group 504-c by temirov farkhod secondary headaches disclosures reference arial 10pt left aligned footer arial 10pt right aligned 2 allergan: advisory board, research support, speaker’s panel amgen: advisory board promius pharma: advisory board supernus: advisory board teva: advisory board eli lilly: advisory board, research support curelator: consultant paid in options 1. to recognize “red flags” for headaches with a discernable cause is it time to rename “secondary headaches”? 2. to reinforce understanding on how to diagnose, manage and treat dangerous and rapidly progressive headaches due to specific causes. 3. to review headaches that we may not encounter on a regular basis. how much of our practice is primary headache disorders due to access re...

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