Cardinal presentations this post is part of a series called cardinal presentations, based on rosens emergency medicine 8th edition. Sacg should be included in the differential diagnosis in individuals older than 40 years presenting with late onset of headaches. The succinct text reflects more than 25 years of handson experience gleaned from advanced training and educating residents and. Differential diagnosis of headache based on 3 questions how long have you been having headaches. Depending on items like medical history, symptoms, test results, own medical knowledge, andor input from colleagues, doctors will usually come up with a handful of possible diagnoses for a particular condition. This allows the clinician to classify the headache as primary or secondary and treat accordingly. Jan 18, 2011 differential diagnosis is the process of determining a specific diagnosis by systematically comparing similar diagnoses. The diagnosis differential includes the migraines of unilateral hemisphere distribution tolosahunt syndrome, trigeminal neuralgia, trigeminoautonomic migraine, migraine with. Oct 23, 2007 chronic daily headaches cdhs refers to primary headaches that happen on at least 15 days per month, for 4 or more hours per day, for at least three consecutive months. Feb 15, 2002 headaches are common during childhood and become more common and increase in frequency during adolescence. Falls may be accidental because of slipping, tripping or environmental hazards or unexplained, when there is no apparent cause. Evaluation and differential diagnosis in adults camfic. Headaches are common during childhood and become more common and increase in frequency during adolescence. New onset explosive acute posttraumatic headache subarachnoid hemorrage thunderclap headache carotid disection stroke pituitary apoplexy new onset, gradual, progressive for hours, days or weeks.
The succinct text reflects more than 25 years of handson experience gleaned from advanced training and educating. Jul 01, 20 the diagnosis and management of facial pain below the eye can be very different dependant on whether the patient visits a dentist or medical practitioner. Full text is available as a scanned copy of the original print version. Headaches in children and adolescents american family physician. Differential diagnosis of headache based on 3 questions. The authors discuss the differential diagnosis and workup of a 38yearold woman who presented with chronic left retroorbital pain and photophobia. The commonest acute causes of pain are dental and these are well managed by dentists. Differential diagnosis of head and neck swelling slideshare uses cookies to improve functionality and performance, and to provide you with relevant advertising. Differential diagnosis between unexplained fall and.
Suspicion for these disorders should be increased in patients with systemic disorders especially immune compromise that predispose to infection with toxoplasma gondii, cryptococcus. Tensiontype headache differentials bmj best practice. The 1988 edition of the primer on the rheumatic diseases, 1 prepared by a committee of the american college of rheumatology acr, lists over 100 disorders in which arthritis may be a significant manifestation. A primary headache is not a symptom of an underlying disease or condition. Malaria must be distinguished from other febrile illnesses to avoid mistreatment. The cardinal symptoms of nph are gait impairment, dementia, and urinary incontinence. The correct diagnosis of migraine without aura versus tensiontype headache is important for correct management of the former condition, as triptans are not effective in tensiontype headache tfelthansen, 2007. Differential diagnosis between unexplained fall and syncop.
It is an important clinical diagnosis because it is a potentially reversible cause of dementia. A summary of headache treatments is also available. Jun 05, 2016 a mass in the neck is an extremely common clinical finding in patients of all age groups. The differential diagnosis of chronic daily headaches.
Early diagnosis of pulmonary embolism pe may reduce morbidity and mortality1. In these cases, a headache diary or headache notebook is given to the patient to obtain longitudinal information for treatment. The diagnosis of cervicogenic headache was confirmed by symptom resolution following. Differential diagnosis of facial pain and guidelines for.
The differential diagnosis of arthritis is exhaustive see table of contents. The approach begins with a search for red flags that suggest the possibility of a secondary. David j fusco, md associate neurosurgeon, barrow neurosurgical associates david j fusco, md is a member of the following medical societies. Unlike migraine, there is no significant nausea, no vomiting, and a lack of a. Suspicion of these disorders mandates emergent diagnostic testing to exclude the disease. A structure for accurate diagnosis is proposed beginning with a very careful history. Epidemiology, molecular classification and who grading of ependymoma. Secondary headaches are characterized by excruciating pain, usually caused by another, more serious, condition. The differential diagnosis of arthritis in childhood. Important elements in the headache history include. Normal pressure hydrocephalus differential diagnoses. Tensiontype headache migraine headache chronic daily headache cluster headache the causes and diagnosis of nonmigraine headaches are.
Headache with focal neurological signs or symptoms. Normal pressure hydrocephalus nph is a clinical symptom complex characterized by abnormal gait, urinary incontinence, and dementia. To be updated when it is complete please like us on facebook, follow us on twitter or subscribe on youtube using the follow us buttons. Migraine headache in adults treatment options epocrates. Tensiontype headache tth imposes a heavy burden on the global population but remains incompletely understood and poorly managed. Diseasecondition differentiating signssymptoms differentiating tests. Differential diagnosis is the process of determining a specific diagnosis by systematically comparing similar diagnoses.
Start studying differential diagnosis for headache. Its clinical diagnosis is based chiefly on negative features that is, absence of symptoms that characterize other primary or secondary headaches. Average age at the time of diagnosis 30 yrs pseudotumor cerebri iih cc. The rational, costeffective evaluation of children with headache begins with a careful.
In a study aimed at identifying clinical factors associated with delayed. Based on the results of many randomized studies, the international guidelines on falls suggest multifactorial. Chronic daily headaches cdhs refers to primary headaches that happen on at least 15 days per month, for 4 or more hours per day, for at least three consecutive months. Each of the other four subjects were diagnosed with speech andor language disorders without the presence of developmental apraxia of speech. Cluster headache is another primary headache that is part of the differential diagnosis for migraine without aura. Such patients should be referred to an ophthalmologist. Jan 09, 2012 normalpressure hydrocephalus nph was the first treatable type of dementia ever described and attracted much interest as soon as it became known. American association of neurological surgeons, american medical association, north american spine society, congress of neurological surgeons disclosure. Although tension type headache is present in up to 78% of headache patients in populationbased studies, it is the least distinct of all headache types.
May 20, 2015 differential diagnosis of head and neck swelling slideshare uses cookies to improve functionality and performance, and to provide you with relevant advertising. The content on the uptodate website is not intended nor recommended as a substitute for medical advice, diagnosis, or treatment. Firstline treatment of adults with acute migraine in the emergency department should include an intravenous antiemetic e. Differential diagnosis for headache acute oxford medical. Migraine headache in adults treatment options epocrates online.
The international classification of headache disorders 3rd edition classifies headaches into primary and secondary headaches. The treatment of both episodic and chronic paroxysmal hemicrania is entirely preventive as attacks are too short and intense for any acute oral treatment to be effective. Tensiontype headaches can be either episodic or chronic. New onset explosive acute posttraumatic headache subarachnoid hemorrage thunderclap headache carotid disection stroke pituitary apoplexy new onset, gradual. The differential diagnosis of headache begins with the headache history, followed by physical exam, laboratory tests and other diagnostic evaluations. Sign in with your personal account to earn and claim cme credits through visualdx. Migraine headache in adults treatment options, diagnosis, and images at epocrates online, the leading provider of drug and disease decision support tools. Differential diagnosis for migraine not for sale or. The differential diagnosis between unexplained fall and syncopal fall can be difficult, if not impossible, because many. The approach begins with a search for red flags that suggest the possibility of a secondary headache.
Radiological diagnosis and differential diagnosis of headache. Ependymoma differential diagnoses medscape reference. The differential diagnosis includes new dailypersistent headache ndph, idiopathic intracranial hypertension, spontaneous low csf pressure headache, and slow variant gca. When the source of pain is different from the site of pain, this is commonly known as referred pain.
Differential diagnosis of chronic migraine clinical. The causes and diagnosis of nonmigraine headaches are discussed here. Migraine headache in adults differential diagnosis. Promethazine can also be used for the symptomatic relief of nausea. Syncope is a transient loss of consciousness loc and, if it occurs when the person is in the upright position, may lead to a fall. Most headaches are caused by one of four syndromes. She was also having generalized headaches in the evening that would resolve with sleep. Oct 19, 2018 normal pressure hydrocephalus nph is a clinical symptom complex characterized by abnormal gait, urinary incontinence, and dementia. At least two reasons account for these observations. Feverweaknesssyncopealtered mental statusseizuredizziness and vertigoheadachesore throatdyspneachest painabdominal painnausea and vomitinggastrointestinal bleedingacute pelvic painback pain. Neil a feldstein, md director of pediatric neurosurgery. Symptoms include dull, nonpulsatile, bilateral, constricting pain not severe. The objectives of this study are to create headache by visual stimulationvs, to examine the similarities between spontaneous headaches and visually stimulated headaches if the latter occurs, to determine if vs can be used as a model in headache researches and to evaluate if it can be used as a diagnostic tool for the differential diagnosis of primary headaches. Gennaro bussone, alan rapoport, in handbook of clinical neurology, 2010.
Appears in 10 books from 19642003 page 371 the impact of radiologic imaging on staging of cancer of the head and neck, semin oncol 18. Patient presentation a 14yearold female came to clinic with a 3day history of increasing neck stiffness. Head and neck is a stellar guide for identifying and diagnosing head and neck disease based on location and neuroimaging results. Which of the following types of primary chronic headache is not one from which chronic migraine must be differentiated. In addition, some facilities do not adequately train. Differential diagnosis of unilateral retroorbital pain. The differential diagnosis between unexplained fall and syncopal fall can be difficult, if not impossible, because many patients have retrograde amnesia after syncope, that is they do not remember their prodromal symptoms.
High resolution ct diagnosis and differential diagnosis swartz jd, bazarnic ml, naidich tp et al. The pain was mainly leftsided and got worse as the day went on. The diagnosis and management of facial pain below the eye can be very different dependant on whether the patient visits a dentist or medical practitioner. If you continue browsing the site, you agree to the use of cookies on this website. Learn vocabulary, terms, and more with flashcards, games, and other study tools. Pdf top 10 differential diagnoses in family medicine. The differential diagnosis and treatment of normalpressure.
Differential diagnosis of diseases diseases of swine wiley. Headaches can be quite debilitating, although most headaches are not caused by lifethreatening disorders. Sometimes pain can be felt in an area that is different from the one in which it originates. A mass in the neck is an extremely common clinical finding in patients of all age groups. Headache can be differentiated in primary and secondary forms. Headaches in children and adolescents american family. Differential diagnosis george washington university. She denied fevers, chills, nausea, emesis, or photophobia or other pain. Differential diagnosis 143 distinctive features of stabbing headache from other types of paroxysmal headache type of headache frequency duration intensity chronobiology location trigge pain dysautonomi migraine variable hd high possible unilateral none pulsating none.
Usually worse in the am and precipitated by changes in posture. Can induced headache be used in the differential diagnosis. For primary headaches, headache trigger trackers and headache diaries can be effective tools to help diagnosis the cause of your headaches. An overview of different forms of secondary headache is given, outlining diagnostic procedures and the morphologic imaging features of each syndrome. The diagnosis is straightforward in the presence of a high fever or altered consciousness. Differential diagnosis of chronic migraine question 1 of 5 which of the following types of primary chronic headache is not one from which chronic migraine must be differentiated. Differential diagnosis for headache flashcards quizlet. Symptomatic malignancy is usually visualized on routine noncontrast head computed tomography ct. The differential diagnosis of cdhs is challenging and should proceed in an orderly fashion. Patients often experience generalized pain and are unable to identify the problem tooth.
Hakim described the entity he called normalpressure hydrocephalus in 1963 e1, e2. Normalpressure hydrocephalus is characterized by a combination of clinical and radiological findings arising in adulthood. Mar 02, 2017 lymph nodes of head and neck and differential diagnosis of cervical lymphadenopathy 1. The patient was in his normal state of good health until three days prior to admission when he was out shopping and felt a headache and rightsided weakness. A fuzzy logic model for differential diagnosis of lower urinary tract. Evaluation of acute headaches in adults american family. Always seek the advice of your own physician or other qualified health care professional regarding any medical questions or conditions.
The differential diagnosis of headache plus focal findings is broad and workup should be guided by the patients profile of other risk factors. The differential diagnosis and treatment of normal. However, most people are not diagnosed because they do not seek medical treatment. Differential diagnosis with noninfectious diseases. Indolent cns infections, however, can be more difficult to diagnose. At the same time, it is the least studied of the primary headache. A few of these conditions have not yet been reported in children. Sep 14, 2015 cardinal presentations this post is part of a series called cardinal presentations, based on rosens emergency medicine 8th edition. In the ensuing years, an initially uncritical enthusiasm for cerebrospinal fluid csf shunting was gradually. Frequently coexists with migraine in the same patient. Neck masses are often the result of inflammation caused by selflimited processes such as viral infections, although the differential diagnosis of a neck mass actually encompasses the entire spectrum of pathology from congenital to infectious to neoplastic. But also a rational and systematic approach to the problem of evaluating and treating.
Cervical artery dissection requires dedicated imaging of the cervical. Get a printable copy pdf file of the complete article 2k, or click on a page image below. Credits can be earned by building a differential or looking up a diagnosis. The mean basal intracranial pressure icp is normal or only mildly elevated upper limit of normal in the supine adult. The chapter provides a general list of possible causes of rectal prolapses including a brief explanation. Differential diagnosis for headache acute common and important causes of headache acute for doctors and medical students this page is currently being written and will be available soon. Tensiontype headache is an uncommon reason for patients to seek medical care, unless it is very frequent and severe. Indomethacin is the drug of choice and it must have controlled the symptoms in order to. Edward hebert school of medicine, bethesda, maryland.
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