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Headache: Catastrophic Updated 4/2010

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BASICS

  • Description
  • Epidemiology
  • Risk Factors
  • Pathophysiology
  • General Prevention
  • Associated Conditions

DIAGNOSIS

  • Signs and Symptoms
  • Tests
  • Differential Diagnosis
  • Medication (Drugs)
  • Interventional
  • Rehabilitation
  • Mental Health/Behavioral
  • Surgery
  • Special Therapy

Follow-up

  • Prognosis
  • Complications
  • Patient Monitoring
The following is an excerpt....
BASICS
Description

A new, often sudden headache related to abnormal pathology or trauma

Epidemiology
Incidence
  • Incidence of mild head injury in the United States is 140 in 100,000
  • Incidence of stroke is 114 in 100,000 in the United States
Prevalence
  • Motor vehicle accidents: 45%
  • Falls: 30%
  • Occupational and recreational accidents: 20%
  • Assaults: 5%
  • Cerebral infarcts: 29%
  • Intracerebral hemorrhage: 57%
  • Arteriovenous malformations: 0.5% in postmortem studies
  • Men are affected more commonly than women, by a ratio of 2:1.
  • Motor vehicle accidents are more common in the young.
  • Falls are more common in the elderly.
  • 50% of all patients with mild head injury are between 15 and 34 years old.
Risk Factors
  • High-risk occupations
  • Adolescents
  • Elderly
  • Diabetes ...

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Figure 18-3 SUBARACHNOID HEMORRHAGE WITH CIRCLEOF WILLIS ANEURYSM. A. CT, Axial Head.Acute blood lies within the subarachnoid space surrounding the branches of the circle of Willis, creating the classic pentagonal shape (arrows). The anterior midline collection lies in the interhemispheric fissure, laterally within the Sylvian fissure and posteriorly over the tentorium. B. Digital Subtraction Angiogram,Cerebral.Contrast, injected after selective catherazation of the internal caroted artery,dearrly identities the aneurysm(arrow). C. Three-Dimensional Time-of-Flight MRA,Cerebral. The aneurysm within the middle cerebral artery isvisible as a localized outpouching (arrow). COMMENT: MRAis a non-invasive modality that can be used to identify aneurysms in high-risk patients. It is, however, a flow-dependent study, and those aneurysms with thrombus or slow flow may not be demonstrated.Credit: Terry R. Yochum, Lindsay J. Rowe, Yochum And Rowe's Essentials of Skeletal Radiology, Third Edition. Philadelphia: Lippincott Williams & Wilkins, 2004.
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