Pain in the cranium, orbits, or upper neck
Pain within the skull is projected to the surface:
Arteries, veins, dura, meninges
Skin, scalp, fascia, muscles
Attributes of the pain—PQRST:
Provocative and palliative features:
Position of the head, coughing or straining (increase suggests elevated ICP), and movement
ABCs if altered mental status
Empiric antibiotics if bacterial meningitis is suspected, acyclovir if immunocompromised
Migraine (See Headach...
Headache secondary to suspected organic disease
Intractable vomiting and dehydration
Pain refractory to outpatient management
Consider ICU admission:
Chlorpromazine: 25–50 mg IM/IV (peds: 0.5–1 mg/kg/dose IM/IV/PO) q4–6h
Dexamethasone: 10–24 mg IV once
Dihydroergotamine: 1 mg IM/IV, repeat q1h; max. dose 3 mg
Ergotamine: 2 mg PO/SL...
The sensitivity for detecting SAH on CT scan falls rapidly after 24 hr. LP remains essential for all patients with suspected SAH presenting after 6 hr of symptom onset.
Edlow JA, Caplan LR, O’Brien K, et al. Diagnosis of acute neurological emergencies in pregnant and post-partum women. Lancet Neurol. 2013;12:175–185.
Perry JJ, Stiell IG, ...
339.00 Cluster headache syndrome, unspecified
346.90 Migraine, unspecified, without mention of intractable migraine without mention of status migrainosus
339.00 Cluster headache ...
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