This is caused by raised CSF pressure, often in middle aged, obese females. It is occasional associated with a VI nerve palsy. It can be caused by SLE, CRF, endocrine problems. Also known as pseusotumour cerebri.
Frontal headache, worse on lying down or stooping, night waking.
Can exacerbate migraines.
Lethargy, tiredness. Get papiloedema.
Need CT and MRI.
Acetazolamide can help. Steroids in first two weeks LP shunt.
Need to monitor vision
Antimigraine treatment may help.
Stabbing unilateral pain. Treat with carbamazepine and oral analgesia. Admit if pain severe.
Consider if headache always on same side. Dull, aching and headaches made worse by lying down or straining.
Central venous thrombosis
Presents similarly to SAH. May be associated with sinus infections, pregnancy and the post-partum period. May be missed on CT, but a clue would be raised intracranial pressure at LP.
several other potential vascular causes of thunderclap headache, other than SAH and these include:
cerebral venous thrombosis
ischaemic or haemorrhagic stroke
intracerebral, intraventricular, extradural or subdural haemorrhage
reversible cerebral vasoconstriction syndrome
Occurs in 5% of patients with a pituitary tumour, and for 80% of patients is the first presentation of the tumour. Sudden onset headache, vomiting, visual impairment and decreased consciousness. Think about if headache + eye signs.
Toxoplasma gondii is an intracellular parasite that infects birds and mammals. Its definitive host is the cat. Excretion of oocytes in its faecal content followed by human contaminated uncooked consumption can lead to human infection. In immunocompetent individuals, it primarily causes a subclinical or asymptomatic infection. In immunocompromised individuals (e.g. AIDS patients), toxoplasmosis is the most common cause of a brain abscess.